[A patient with cryoglobulinemia and hepatitis C]

We describe a 73-year-old woman who presented with purpura, recurrent ulcerations of both lower limbs as well as worsening of her condition. Laboratory tests revealed a mixed cryoglobulinemia (type-II). Two years after diagnosis, an amputation of the right femur had been performed due to extensive necrotizing ulcerations. Further complications such as membranoproliferative glomerulonephritis, cirrhosis of the liver with portal hypertension and ultimately, hepatocellular carcinoma developed. A chronic hepatitis C infection was diagnosed rather late, mainly because of the false negative results of the first generation EIA. This case report illustrates the various complications-hepatic and extrahepatic-of chronic hepatitis C infection. The pathogenesis of mixed cryoglobulinemia remains unclear. However, a current literature review suggests a strong association with chronic hepatitic C. Diagnosis, clinical features and course of hepatitis C infection are discussed.