Hepatitis C virus infection with and without cryoglobulinemia as a case ofChurg-Strauss syndrome

Chronic hepatitis C virus (HCV) infection may be associated with numerous i mmune disorders, with vasculitis including polyarteritis nodosa, or with bo th. Cryoglobulinemia. which is often present, can also be expressed by vasc ulitis. We describe 2 cases of Churg-Strauss syndrome (CSS) in patients wit h HCV infection. We found no previous case of CSS accompanying HCV infectio n in the literature. The current patients were women aged 40 and 66 years. In both cases, a clinical and laboratory pattern suggesting CSS was found b efore the HCV infection was discovered. One patient had cryoglobulinemia. O ne patient was successfully treated with interferon (IFN). The other was tr eated fur 18 months with IFN and corticosteroids. Second-line therapy consi sting of IFN with ribavirin was successful. The emergence of HCV infection may have led to all induced form of CSS. The relationship among HCV, cryogl obulinemia, and CSS is nor clear, but may be similar to that existing betwe en polyarteritis nodosa and hepatitis B virus. These observations suggest t hat IFN-alpha therapy may be effective against CSS in HCV infected patients with or without cryoglobulinemia.