Complete remission of cryoglobulinemic glomerulonephritis (HCV-positive) after high dose interferon therapy

We report the case of a 64-year old woman with hepatitis C virus infection, mixed cryoglobulinemia type II (IgG+IgM kappa) and cryoglobulinemic glomer ulonephritis. The patient was treated with the standard dose of recombinant interferon alpha-2b (3 million units 3 times a week) for one year, resulti ng in complete clinical remission and undetectable levels of serum hepatiti s C virus RNA. AST and ALT normalized and proteinuria decreased from 2,78 t o 0,98 g/day. However, a relapse occurred when therapy was slopped. Additio nal therapy with interferon-alpha (5 million units 3 times a week for 9 mon ths) resulted again in quick and prolonged remission. The clinical course o f our patient showed sustained clinical and virologic response after high-d ose interferon-alpha treatment confirming the usefulness of interferon alph a in treatment of patients with cryoglobulinemic glomerulonephritis. Our ob servation is in agreement with others, suggesting that recommended standard dosage and duration of initial treatment with interferon alpha should be r e-evaluated. Although our patient had sustained virologic and clinical resp onse after interferon alpha monotherapy, recent studies clearly support com bination therapy of interferon alpha and ribavirin for treatment of chronic HCV infections.