Hepatitis C virus positive patient diagnosed after detection of atypical cryoglobulin  

作　　者：Belkiz Ongen Fehime Benli Aksungar Bahattin Cicek Isin Akyar Abdurrahman Coskun Mustafa Serteser Ibrahim Unsal 

机构地区：[1]Department of Biochemistry, Acibadem Labmed Clinical Labo-ratories [2]Department of Biochemistry, Acibadem University, School of Medicine [3]Department of Internal Medicine-Gastroen-terology, Acibadem University, School of Medicine [4]Department of Microbiology, Acibadem University, School of Medicine

出　　处：《World Journal of Clinical Cases》2016年第3期81-87,共7页世界临床病例杂志

摘　　要：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 Ig A 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.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 Ig A 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.

关 键 词：CRYOGLOBULINEMIA Hepatitis C Immunosu-btraction Immunotyping ELECTROPHORESIS 

分 类 号：R512.63[医药卫生—内科学] R55[医药卫生—临床医学]