Relationship of tissue deposits of cryoglobulin to clinical features of mixed cryoglobulinemia

Feiner, Helen

doi:10.1016/s0046-8177(83)80144-0

Cited by 38 publications

(13 citation statements)

References 21 publications

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“…The high prevalence of PN in HCV patients without other symptoms related to mixed cryoglobulinaemia is also compatible with a role for HCV itself in the pathogenesis of damage 14. Since the study of Feiner published in 1983—before HCV was discovered—it has been known that vasculitic lesions in patients with cryoglobulinaemia are not identical in each organ 15. The first case described in this pathological report is certainly an HCV-mixed cryoglobulinaemia (type II mixed cryoglobulinaemia with IgMκ component) vasculitis with purpura and glomerulonephritis, with identical deposits in normal cutaneous vessels and kidney.…”

Section: Discussionmentioning

confidence: 77%

Hepatitis C virus infection with peripheral neuropathy is not always associated with cryoglobulinaemia

Lidove

2001

Annals of the Rheumatic Diseases

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Objectives-To describe cases of peripheral neuropathy associated with chronic hepatitis C virus infection without mixed cryoglobulinaemia. Methods-Four cases of peripheral neuropathy associated with chronic hepatitis C virus infection with persistent negativity of mixed cryoglobulinaemia were found. Results-All patients had small increases of transaminase levels and a positive viraemia. Liver biopsy showed chronic active hepatitis in all but one case (Knodell 4-9, Metavir A0F0-A3F3). Neuromuscular biopsy showed axonal neuropathy associated with lymphoid infiltrates around small vessels in two cases. Rheumatoid factor was always negative and C4 complement level was always normal. In three patients, neuropathy improved with interferon , interferon + ursodesoxycholic acid, or steroids + plasma exchange. Conclusion-Peripheral neuropathy may be associated with hepatitis C virus infection without mixed cryoglobulinaemia.

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Section: Discussionmentioning

confidence: 77%

Hepatitis C virus infection with peripheral neuropathy is not always associated with cryoglobulinaemia

Lidove

2001

Annals of the Rheumatic Diseases

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“…I meccanismi attraverso i quali si realizza il danno del nervo periferico non sono stati ancora del tutto definiti. Sono stati presi in considerazione una demielinizzazione immunomediata (21), una interferenza con il microcircolo dei vasa nervorum da precipitazione intravascolare di crioglobuline o una vasculite dei vasa nervorum (21-23). Ferri et al (12) ritengono che le lesioni del nervo periferico nella CM possano essere soprattutto di origine vascolare e che contribuiscano alla patogenesi le alterazioni emoreologiche rilevabili in questa condizione (24).…”

Section: Discussioneunclassified

Peripheral nervous system involvement in HCV-related mixed cryoglobulinemia

Migliaresi¹,

Iorio²,

Ammendola³

et al. 2011

Reumatismo

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INTRODUZIONE Il virus C dell'epatite (HCV) è un virus epatotropo e linfotropo e ad esso sono state riferite diverse patologie extraepatiche (1). In particolare un'infezione cronica da HCV è all'origine della stragrande maggioranza dei casi di crioglobulinemia mista (CM) (2, 3), condizione caratterizzata dalla presenza in circolo di immunocomplessi crioprecipitabili, costituiti principalmente da IgG e da IgM con attività di fattore reumatoide (4). Nella CM di tipo III il fattore reumatoide è policlonale, in quella di tipo II è monoclonale (5). Una CM può essere rilevata occasionalmente anche in soggetti asintomatici, ma in genere i pazienti con CM tendono a realizzare una sindrome crioglobulinemica (SC). Nella originaria descrizione di Meltzer e Franklin (4) la SC viene riportata soprattutto come triade di porpora, astenia e artralgie, ma viene rilevato come nel tempo essa possa configurarsi come malattia sistemica. La possibilità di un interessamento del sistema nervoso periferico (SNP) in questa condizione, pur riconosciuta da diverso tempo (4, 6, 7), è stata oggetto di attenzione soltanto negli ultimi anni (8)(9)(10)(11)(12)). Ancora non del tutto definiti sono i meccanismi attraverso i quali si realizza il danno del nervo. Scopo del nostro studio è stato valutare la prevalenza e le caratteristiche della neuropatia periferica (NP) in pazienti con SC HCV-correlata e individuare i possibili meccanismi patogenetici. Interessamento del sistema nervoso periferico nella crioglobulinemia mista HCV-correlataPeripheral nervous system involvement in HCV-related mixed cryoglobulinemia

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“…The pathogenic mechanisms of ANS involvement in MC are still not identified. MC related PN is commonly considered a vasomediated axonopathy due to occlusion of the vasa nervorum by cryoglobulin intravascular precipitation and/or vasculitis of vasa nervorum [7,10]. However, due to their small calibre autonomic nerve fibres should be relatively spared by hypoxic-ischaemic damage, therefore pathogenic mechanisms not yet known should play a role in determining MC related AN.…”

Section: Discussionmentioning

confidence: 99%

Autonomic neuropathy in mixed cryoglobulinemia

Ammendola

Sampaolo

Migliaresi³

et al. 2007

J Neurol

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A retrospective, cross-sectional study was performed on a series of HCV-related mixed cryoglobulinemia (HCV-MC) patients to assess autonomic neuropathy (AN) and its relation to peripheral neuropathy (PN). Thirty consecutive patients affected by HCV-MC underwent clinical, neurological and electrodiagnostic examinations. Autonomic nervous system (ANS) involvement was assessed by functional cardiovascular tests and sympathetic skin response (SSR) evaluation. Sural nerve biopsy was performed in 10 patients with PN. All patients received steroids, 15 also received recombinant interferon-alpha2b (RIfn-alpha2b). PN occurred in 27 patients (90.0%) and AN in 4 (13.3 %) all with signs of PN. SSR was the autonomic test more frequently altered. Biopsy disclosed axonal degeneration more evident in the 4 patients with AN. Three out of 4 patients with AN received steroids and rIFN-alpha2b and 1 steroids alone. In our study on HCV-MC, it was concluded that AN can occur also without dysautonomic symptoms, SSR appears to be one of the optional tests to use together with dysautonomic tests to identify AN and finally PN and AN do not seem to be positively influenced by addition of rIFN-alpha2b to steroid treatment.

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Relationship of tissue deposits of cryoglobulin to clinical features of mixed cryoglobulinemia

Cited by 38 publications

References 21 publications

Hepatitis C virus infection with peripheral neuropathy is not always associated with cryoglobulinaemia

Hepatitis C virus infection with peripheral neuropathy is not always associated with cryoglobulinaemia

Peripheral nervous system involvement in HCV-related mixed cryoglobulinemia

Autonomic neuropathy in mixed cryoglobulinemia

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