A. Fayyazi et al., CLINICAL, BIOCHEMICAL, AND HISTOLOGICAL-CHANGES IN HEPATITIS-C VIRUS INFECTION-ASSOCIATED CRYOGLOBULINEMIA, Zeitschrift fur Gastroenterologie, 35(10), 1997, pp. 921-928
The most common extrahepatic manifestation of HCV infection is mixed c
ryoglobulinemia (MC). 62 unselected patients with chronic HCV infectio
n were prospectively evaluated for the presence of cryoglobulinemia an
d associated clinical and biochemical parameters. Furthermore, a putat
ive relationship between the HCV genotypes and cryoglobulinemia was te
sted, Histological features typical for HCV infection were comparative
ly analyzed in cases with and without cryoglobulinemia, Whether an int
rahepatic Th2-response is responsible for the strong antibody producti
on causing cryoglobulinemia was also examined. Cryoglobulins were dete
cted in sera of 30 patients (congruent to 48%). Patients with cryoglob
ulinemia were on the average elder, showed an apparent longer duration
of infection, and suffered more frequently from arthralgia, accompani
ed by a significant increase of total serum IgM concentration and rheu
matoid factor activity. The HCV genotype distribution among patients w
ith cryoglobulinemia was not different from that found in patients wit
hout cryoglobulinemia. In cases with cryoglobulinemia, an increased ac
tivity of chronic hepatitis and a higher grade of liver fibrosis was n
oted, The prevalence of HCV-typical histological lesions among all pat
ients were: Portal lymphocytic aggregates (40%), bile duct damage (35%
), steatosis (47%), and intracellular acidophilic bodies (29%). A sign
ificant correlation, however, could not be found between cryoglobuline
mia and the presence of HCV-typical histological lesions, An intrahepa
tic Th2-response causing an increased antibody production could not be
observed in cases with cryoglobulinemia.