Membranoproliferative Glomerulonephritis and Leukocytoclastic Vasculitis without Cryoglobulin in Chronic Hepatitis C Virus Infection

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  • NAKAJIMA Ayako
    The Division of Rheumatology, Tokyo Metropolitan Ohtsuka Hospital
  • ADACHI Masayuki
    The Division of Rheumatology, Tokyo Metropolitan Ohtsuka Hospital
  • TANAKA Michi
    The Division of Rheumatology, Tokyo Metropolitan Ohtsuka Hospital
  • SUWA Akira
    The Division of Rheumatology, Tokyo Metropolitan Ohtsuka Hospital
  • YASUKI Yoshihiro
    Division of Dermatology, Tokyo Metropolitan Ohtsuka Hospital
  • IMAEDA Hiroyuki
    Division of Internal Medicine, Tokyo Metropolitan Ohtsuka Hospital
  • INADA Shinichi
    The Division of Rheumatology, Tokyo Metropolitan Ohtsuka Hospital

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Abstract

The etiopathogenesis of extrahepatic manifestations including vasculitis in the context of HCV infection is still unknown. We report a case with lethal extrahepatic manifestations due to chronic hepatitis C virus (HCV) infection. The patient presented leukocytoclastic vasculitis, sensorimotor neuropathy and membranoproliferative glomerulonephritis with positive rheumatoid factor but lacked cryoglobulin. Hypocomplementaemia and deposition of IgM and C3 in the vascular lesion and glomeruli suggested that immune complex disease played a role in the pathogenesis of extrahepatic manifestations independent of cryoglobulin. Although HCV was successfully eliminated by treatment with interferon α, she died of cryptococcal infection.<br>(Internal Medicine 42: 1042-1046, 2003)

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  • Internal Medicine

    Internal Medicine 42 (10), 1042-1046, 2003

    The Japanese Society of Internal Medicine

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