TY - JOUR
T1 - Polyarteritis nodosa and cryoglobulinemic glomerulonephritis related to chronic hepatitis C
AU - Canada, Robert
AU - Chaudry, Sufiyan
AU - Gaber, Lillian
AU - Waters, Bradford
AU - Martinez, Antonio
AU - Wall, Barry
PY - 2006/6/1
Y1 - 2006/6/1
N2 - 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.
AB - 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.
KW - Cholecystitis
KW - Cryoglobulinemia
KW - Hepatitis C
KW - Polyarteritis
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U2 - 10.1097/00000441-200606000-00008
DO - 10.1097/00000441-200606000-00008
M3 - Article
C2 - 16775442
AN - SCOPUS:33745259925
VL - 331
SP - 329
EP - 333
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
SN - 0002-9629
IS - 6
ER -