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[A case of hepatitis C virus-related mixed cryoglobulinemic vasculitis with chronic diarrhea]
Fumitaka Mizuno1, Takayoshi Fujita1, Masaya Morii1
1Department of Gastroenterology, Okazaki Municipal Hospital.
Insights
Hepatitis C virus (HCV) infection can trigger mixed cryoglobulinemic vasculitis, causing gastrointestinal and neurological symptoms. Early diagnosis and treatment are crucial for managing this rare HCV complication.
Area of Science:
- Gastroenterology
- Rheumatology
- Infectious Diseases
Background:
- Chronic Hepatitis C Virus (HCV) infection is a significant global health concern.
- Mixed cryoglobulinemic vasculitis is a rare but serious complication associated with chronic HCV infection.
Observation:
- A woman in her 50s with a history of chronic HCV presented with arthralgia, diarrhea, and fever.
- Initial colonoscopy revealed ileal erosions and non-specific enterocolitis.
- Subsequent admission showed worsening neuropathy, proteinuria, skin rash, abdominal pain, and bloody stools.
Findings:
- Repeat colonoscopy identified colonic erosions with evidence of vascular narrowing on biopsy.
- Serum cryoglobulin was detected.
- The clinical presentation and laboratory findings were consistent with Hepatitis C virus-related mixed cryoglobulinemic vasculitis.
Implications:
- This case highlights the diverse and severe manifestations of HCV-related vasculitis.
- Prompt recognition of vasculitis in HCV patients is essential for timely intervention.
- Effective management of underlying HCV infection is critical for controlling vasculitis activity.
Abstract:
A woman in her 50s with a medical history of chronic hepatitis C virus (HCV) infection presented to our hospital with arthralgia, diarrhea, and fever. We performed colonoscopy and found scattered erosions at the terminal ileum. Furthermore, the biopsy specimen from the ileum and colon showed non-specific enterocolitis. Two weeks later, she was admitted to our hospital due to worsening neuropathy, proteinuria, and skin rash. On the next day, her abdominal pain worsened, and she had bloody stools. Repeat colonoscopy performed without bowel preparation revealed multiple erosions at the colon, and biopsy specimen from the colon exhibited narrowing of the lumen of the blood vessels. The presence of serum cryoglobulin and untreated chronic HCV infection is consistent with the diagnosis of hepatitis C virus-related mixed cryoglobulinemic vasculitis.
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