HCV Extrahepatic Events: Cryoglobulinemic Syndrome – A Case Report in an Over-70-Year Old Patient

Abstract

Mixed Cryoglobulinemia (MC) is the most severe among the extrahepatic manifestations of hepatitis C virus. It is a circulating immune disease due to a virus-induced proliferative disorder of B lymphocytes, mainly involving low and medium-sized vessels. Diagnosis of cryoglobulinemia is based upon the presence in the serum of immunoglobulins which may reversibly precipitate at temperature inferior to 37°C. Presentation of Case: In the present paper we report an interesting case of a 72-year-old man with MC. The two main findings in MC are vasculitis and neuropathic syndrome. Cryoglobulinemic syndrome is characterized by purpura, which is one of the earliest and common clinical manifestations in over 80% of the cases. In this case report the neurological picture is represented by severe sensorimotor polyneuropathy, characterized by burning dysesthesia and lack of sensitivity and strength in the limbs. Discussion and Conclusion: The therapeutic approach to the patient with cryoglobulinemic syndrome should be tailored to the clinical characteristics of the patient and the degree of disease activity. The present clinical picture occurring with severe neurological impairment may be included among the most severe forms of the disease.