A case of HCV positive cryoglobulinemic focal necrotizing glomerulonephritis with generalized purpura

Yıl 2023, , 22 - 25, 30.04.2023

Aysun Yakut

https://doi.org/10.35514/mtd.2023.84

Öz

In addition to chronic liver disease, hepatitis C (HCV) can cause many non-hepatic symptoms and signs such as hematological, dermatological, renal, autoimmune and neurological disorders. Small vessels due to the accumulation of the immune complex and complement unit. HCV infection is the most obvious secondary cause of the disease. Immune complexes settle in endothelial cells and activate all pathways of the immune system and cause damage accordingly. They also cause some systemic diseases in the central nervous system, kidneys, skin and other internal organs. Membranoproliferative glomerulonephritis has been reported in more than a quarter of HCV cases. Results obtained from patients followed for 21 years indicate that renal involvement is a sign of malignant prognosis. However, end-stage renal disease is not common in these patients. Detection of circulating crioglubulins in the laboratory, hypocomplementemia and rheumatoid factor (RF) positivity help in the diagnosis of HCV serology. These patients typically show low C4 values and normal or near-normal C3 values. In our case, active chronic HCV positivity was discussed over the patient who was consulted to the nephrology service because of nephrotic level proteinuria, hematuria, renal failure and generalized exanthema.

Anahtar Kelimeler

HCV, focal necrotizing glomerulonephritis, mixed cryoglobulinemia, mixed cryoglobulinemia, rituximab

Jeneralize ekzantemi bulunan kriyoglobulinemik fokal nekrotizan glomerulonefritli HCV pozitif vakası

Öz

In addition to chronic liver disease, hepatitis C (HCV) can cause many non-hepatic symptoms and signs such as hematological, dermatological, renal, autoimmune and neurological disorders. Small vessels due to the accumulation of the immune complex and complement unit. HCV infection is the most obvious secondary cause of the disease. Immune complexes settle in endothelial cells and activate all pathways of the immune system and cause damage accordingly. They also cause some systemic diseases in the central nervous system, kidneys, skin and other internal organs. Membranoproliferative glomerulonephritis has been reported in more than a quarter of HCV cases. Results obtained from patients followed for 21 years indicate that renal involvement is a sign of malignant prognosis. However, end-stage renal disease is not common in these patients. Detection of circulating crioglubulins in the laboratory, hypocomplementemia and rheumatoid factor (RF) positivity help in the diagnosis of HCV serology. These patients typically show low C4 values and normal or near-normal C3 values. In our case, active chronic HCV positivity was discussed over the patient who was consulted to the nephrology service because of nephrotic level proteinuria, hematuria, renal failure and generalized exanthema.

Anahtar Kelimeler

HCV, focal necrotizing glomerulonephritis, mixed cryoglobulinemia, mixed cryoglobulinemia, rituximab

Kaynakça

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