Hypocomplementaemic urticarial vasculitis, interstitial lung disease and hepatitis C

A 42-year-old man developed persistent urticaria and angio-oedema responsive to systemic steroids. A skin biopsy revealed leucocytoclastic vasculitis. C4 levels were consistently decreased in the setting of a mildly elevated erythrocyte sedimentation rate. Pulmonary function studies revealed a restrictive pattern, and there was eosinophilia in bronchial lavage fluid. Antibody to hepatitis C virus was positive, and there was mild elevation of serum aminotransferase. We believe that this case represents another possible manifestation of immunological disease associated with hepatitis C virus infection.