Polyarteritis nodosa and cryoglobulinemic glomerulonephritis related to chronic hepatitis C

Robert Canada, Sufiyan Chaudry, Lillian Gaber, Bradford Waters, Antonio Martinez, Barry Wall

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

CASE REPORT: A 53-year-old man with hepatitis C virus (HCV) infection underwent cholecystectomy for presumed cholecystitis. Gallstones were not present, and histological examination demonstrated medium-sized arteritis, consistent with polyarteritis nodosa (PAN). The patient later developed rapidly progressive glomerulonephritis. Kidney biopsy demonstrated cryoglobulinemic glomerulonephritis. Because of the severity of the patient's vasculitic manifestations, treatment included pulse methylprednisolone followed by oral prednisone and monthly intravenous cyclophosphamide for 6 months. During treatment, microhematuria resolved, proteinuria decreased, and serum creatinine concentration stabilized. The patient subsequently underwent treatment for HCV with interferon resulting in a marked decrease in HCV RNA. The patient has had no relapse of his vasculitis, his renal function is stable, and viral load remains low after completing 36 weeks of interferon. CONCLUSION: Life-threatening vasculitis related to HCV was successfully treated with immunosuppressive therapy. After obtaining clinical remission, antiviral therapy was instituted, resulting in a dramatic decrease in HCV RNA.

Original languageEnglish (US)
Pages (from-to)329-333
Number of pages5
JournalAmerican Journal of the Medical Sciences
Volume331
Issue number6
DOIs
StatePublished - Jun 1 2006

Keywords

  • Cholecystitis
  • Cryoglobulinemia
  • Hepatitis C
  • Polyarteritis

ASJC Scopus subject areas

  • Medicine(all)

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