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العنوان
Study of cryoglobulinemia in chronic hepatitis C patients
المؤلف
Abd El-Fattah Mohammed,Mohammed
الموضوع
Natural History of Hepatitis C Viral Infection.
تاريخ النشر
2008 .
عدد الصفحات
203.P؛
الفهرس
Only 14 pages are availabe for public view

from 205

from 205

Abstract

Hepatitis C virus (HCV) is involved in an increasing number of non hepatic diseases. Mixed cryoglobulinemia (MC) is considered a lymphoproliferative disorder. It is characterized by arthralgia, weakness, purpura and organ involvement such as membranoproliferative glomerulonephritis, peripheral neurophathy, vasculitis and chronic liver diseases. The term essential mixed cryoglobulinemia (EMC) has been used to describe the syndrome with no evidence of underlying disease.
Chronic HCV infection is the main cause (90%) of EMC type II and III with or without clinical or biochemical evidence of liver damage. Anti HCV antibodies, HCV proteins and HCV-RNA have, been found in the cryoprecipitate in concentrated form. Several HCV genotypes are involved in the pathogenesis of the disease. Cryoglobulinemia is quite frequent in chronic HCV infection and when appropriate techniques of cryoglobulin detection are applied. Its frequency is usually higher than 40% are more frequently females, cirrhosis and have a longer duration of HCV infection. Only a minority (approximately 10%) is associated with MC disease. HCV as a lymphotropic virus may play a direct role in the development of low grade non Hodgkin’s lymphoma usually associated with EMC.
Approximately 50% of patients with hepatitis C associated MC appear to respond to interferon alfa 3-5 MU given three times veek1y for 12-18 months.
A rebound phenomenon of clinical and serologic parameters is frequently observed after therapy discontinuation (Doupakis and Boki 1997)
Aiming to estimate cryoglobulin in patients with CHC viral infection to identify the possible correlation between cryoglobulinemia and CHC viral infection, we conducted this study on 40 patients with CHC viral infection.
All Patients were subjected to:
Full medical history, full clinical examination, abdominal ultrasonography, laboratory investigations including: anti-HCV antibodies by third generation ELISA, liver function tests ( ALT, AST, total and direct bilirubin, serum albumin and total proteins PT, PTT and INR ), kidney function tests (serum creatinine, BUN, serum sodium and potassium), complete blood count( WBCs, RBCs, hemoglobin and platelet count), urine and stool examination and cryoglobulin in chilled serum.

We found that 10 patients (20%) out of 50 patients have cryoglobulinemia in their sera, purpura in cryoglobulin positive patients was 20% and in cryoglobulin negative patients was 10%, itching in cryoglobulin positive patients was 10% and in cryoglobulin negative patients was 17.5%, fever in cryoglobulin positive patients was 10% and in cryoglobulin negative patients was 22.5% and jaundice in cryoglobulin positive patients was 20% and in cryoglobulin negative patients was 27.5%, yet these parameters shows no statistically significant difference; however arthralgia in cryoglobulin positive patients was significantly higher than in cryoglobulin negative patients (20% vs 2.5%) ,the only laboratory parameter that showed significant difference between both groups was the INR (1.4±0.1 vs 1.3±0.2).