A Young Lady with Hypertension - Rare Presentation of a Common Disease

Hypertension is a common finding in patients with renal impairment but it is frequently difficult to establish if one feature is the cause or the effect of the other. Even rarer is the identification of an underlying cause for hypertension or renal failure in such patients. We present a case of hypertension in a young lady as part of nephritic syndrome due to HCV associated essential mixed cryoglobulinemia. She presented with difficult to control hypertension and deranged renal functions. On detailed evaluation, she was found to have nephritic syndrome as part of essential mixed cryoglobulinemia. She tested positive for HCV RNA and underwent treatment with combination of standard interferon and ribavirin. All her symptoms were relieved with this treatment, HTN subsided and renal function tests returned to normal values. Her HCV RNA was negative at the end of treatment as well as 6 months later; confirming a sustained virological response.