Open AccessHepatitis C virus positive patient diagnosed after detection of atypical cryoglobulin
Author(s) -
Belkız Öngen,
Fehime Benli Aksungar,
Bahattin Çıçek,
Işın Akyar,
Abdurrahman Coşkun,
Mustafa Serteser,
İbrahim Ünsal
Publication year - 2016
Publication title -
world journal of clinical cases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.368
H-Index - 10
ISSN - 2307-8960
DOI - 10.12998/wjcc.v4.i3.81
Subject(s) - medicine , cryoglobulin , cryoglobulins , cryoglobulinemia , hepatitis c virus , immunofixation , hepatitis c , pathology , liver biopsy , jaundice , vasculitis , rash , gastroenterology , immunology , monoclonal , antibody , biopsy , dermatology , virus , monoclonal antibody , disease
A 60-year-old male patient presented with jaundice and dark urine for three days, icteric sclerae and skin rash on his legs for six months. Laboratory investigations revealed an atypical cryoglobulinemia with high hepatitis C virus (HCV)-RNA levels. Imaging studies showed cholestasis was accompanying HCV. Capillary zone electrophoresis using immunosubtraction method revealed a polyclonal immunoglobulin G and immunoglobulin A (IgA) monoclonal cryoglobulin and that IgA lambda was absent in immunofixation electrophoresis. After a liver biopsy, chronic hepatitis C, HCV related mixed cryoglobulinemia and cryoglobulinemic vasculitis were diagnosed and antiviral therapy was initiated. Our HCV patient presented with cryoglobulinemic symptoms with an atypical cryoglobulinemia that was detected by an alternative method: Immunosubtraction by capillary electrophoresis. Different types of cryoglobulins may therefore have a correlation with clinical symptoms and prognosis. Therefore, the accurate immunotyping of cryoglobulins with alternative methods may provide more information about cryoglobulin-generated pathology.