HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature review

Mixed cryoglobulinemia is the most prevalent extrahepatic manifestation of chronic HCV infection. It is usually a benign lymphoproliferative disorder which presents as vasculitis affecting different organs. Although life-threatening cryoglobulinemic vasculitis (CryoVas) is rare, it is sometimes the...

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Main Authors: Snezana Arandjelovic, Branka Bonaci-Nikolic, Aleksandra Peric-Popadic, Vesna Tomic-Spiric, Jasna Bolpacic, Sanvila Raskovic, Sladjana Andrejevic
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2017-06-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/8290
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author Snezana Arandjelovic
Branka Bonaci-Nikolic
Aleksandra Peric-Popadic
Vesna Tomic-Spiric
Jasna Bolpacic
Sanvila Raskovic
Sladjana Andrejevic
author_facet Snezana Arandjelovic
Branka Bonaci-Nikolic
Aleksandra Peric-Popadic
Vesna Tomic-Spiric
Jasna Bolpacic
Sanvila Raskovic
Sladjana Andrejevic
author_sort Snezana Arandjelovic
collection DOAJ
description Mixed cryoglobulinemia is the most prevalent extrahepatic manifestation of chronic HCV infection. It is usually a benign lymphoproliferative disorder which presents as vasculitis affecting different organs. Although life-threatening cryoglobulinemic vasculitis (CryoVas) is rare, it is sometimes the first and possibly lethal complication. Its treatment depends on the severity of vasculitis and can be challenging. High dose of corticosteroids, immunosuppressive agents and plasma exchange represent the first-line treatment, which should be followed by antiviral therapy. Rituximab is an effective and safe treatment option. However, the data about its use in life-threatening conditions are scarce. We report the case of a patient with severe, relapsing and life-threatening HCV-related CryoVas  resistant to standard therapy who had had an initial beneficial response to rituximab added to plasma exchange that was later compromised by the development of sepsis. We also review the literature and discuss manifestations and therapy of life-threatening Cryovas with focus on rituximab use.
format Article
id doaj-art-1c40b4697d0f48d7b4eb3c9d44fe840e
institution Kabale University
issn 1972-2680
language English
publishDate 2017-06-01
publisher The Journal of Infection in Developing Countries
record_format Article
series Journal of Infection in Developing Countries
spelling doaj-art-1c40b4697d0f48d7b4eb3c9d44fe840e2025-08-20T03:52:42ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802017-06-01110510.3855/jidc.8290HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature reviewSnezana Arandjelovic0Branka Bonaci-Nikolic1Aleksandra Peric-Popadic2Vesna Tomic-Spiric3Jasna Bolpacic4Sanvila Raskovic5Sladjana Andrejevic6Clinical Centre of Serbia, Belgrade, SerbiaClinical Centre of Serbia, Belgrade, SerbiaClinical Centre of Serbia, Belgrade, SerbiaClinical Centre of Serbia, Belgrade, SerbiaClinical Centre of Serbia, Belgrade, SerbiaClinical Centre of Serbia, Belgrade, SerbiaClinical Centre of Serbia, Belgrade, Serbia Mixed cryoglobulinemia is the most prevalent extrahepatic manifestation of chronic HCV infection. It is usually a benign lymphoproliferative disorder which presents as vasculitis affecting different organs. Although life-threatening cryoglobulinemic vasculitis (CryoVas) is rare, it is sometimes the first and possibly lethal complication. Its treatment depends on the severity of vasculitis and can be challenging. High dose of corticosteroids, immunosuppressive agents and plasma exchange represent the first-line treatment, which should be followed by antiviral therapy. Rituximab is an effective and safe treatment option. However, the data about its use in life-threatening conditions are scarce. We report the case of a patient with severe, relapsing and life-threatening HCV-related CryoVas  resistant to standard therapy who had had an initial beneficial response to rituximab added to plasma exchange that was later compromised by the development of sepsis. We also review the literature and discuss manifestations and therapy of life-threatening Cryovas with focus on rituximab use. https://jidc.org/index.php/journal/article/view/8290hepatitis C virushepatitis C virus (HCV)HCVcryoglobulinemic vasculitislife-threatening cryoglobulinemiarituximab
spellingShingle Snezana Arandjelovic
Branka Bonaci-Nikolic
Aleksandra Peric-Popadic
Vesna Tomic-Spiric
Jasna Bolpacic
Sanvila Raskovic
Sladjana Andrejevic
HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature review
Journal of Infection in Developing Countries
hepatitis C virus
hepatitis C virus (HCV)
HCV
cryoglobulinemic vasculitis
life-threatening cryoglobulinemia
rituximab
title HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature review
title_full HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature review
title_fullStr HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature review
title_full_unstemmed HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature review
title_short HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature review
title_sort hcv related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab case report and literature review
topic hepatitis C virus
hepatitis C virus (HCV)
HCV
cryoglobulinemic vasculitis
life-threatening cryoglobulinemia
rituximab
url https://jidc.org/index.php/journal/article/view/8290
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