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Unveiling Mixed Cryoglobulinemia in Suspected Sepsis Without a Source
Eder Luna-Ceron1, Lakshmi Kattamuri1, Katherine Vidal2
1Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
Cureus
|May 6, 2024
Summary
Direct-acting antivirals have shifted mixed cryoglobulinemia causes from Hepatitis C to autoimmune disorders. This case highlights mixed cryoglobulinemia in a Hepatitis C patient, benefiting from DAA treatment.
Area of Science:
- Rheumatology
- Hepatology
- Immunology
Background:
- Mixed cryoglobulinemia involves immune complexes causing symptoms like joint pain.
- Hepatitis C virus (HCV) was a primary cause, but direct-acting antivirals (DAAs) have changed etiology.
- Autoimmune and lymphoproliferative disorders are now more common causes.
Observation:
- A 67-year-old woman with HCV-related cirrhosis presented with septic shock and severe joint pain.
- Sepsis was treated, but persistent pain led to further investigation.
- Diagnosis confirmed mixed cryoglobulinemia with hypocomplementemia and positive rheumatoid factors.
Findings:
- The case highlights mixed cryoglobulinemia in a chronic Hepatitis C patient with persistent joint pain.
- This emphasizes considering mixed cryoglobulinemia even without classic symptoms.
- DAA treatment for HCV offers dual benefits: viral clearance and symptom relief.
Implications:
- DAA therapy for Hepatitis C can resolve mixed cryoglobulinemia symptoms.
- Early diagnosis and treatment are crucial for preventing organ damage.
- Understanding evolving etiologies of mixed cryoglobulinemia is vital for patient management.
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