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World J Clin Cases. 2016 Mar 16;4(3):81-7. doi: 10.12998/wjcc.v4.i3.81.

Hepatitis C virus positive patient diagnosed after detection of atypical cryoglobulin.

World journal of clinical cases

Belkiz Ongen, Fehime Benli Aksungar, Bahattin Cicek, Isin Akyar, Abdurrahman Coskun, Mustafa Serteser, Ibrahim Unsal

Affiliations

  1. Belkiz Ongen, Fehime Benli Aksungar, Isin Akyar, Abdurrahman Coskun, Mustafa Serteser, Ibrahim Unsal, Department of Biochemistry, Acibadem Labmed Clinical Laboratories, 34435 Istanbul, Turkey.

PMID: 26989673 PMCID: PMC4792169 DOI: 10.12998/wjcc.v4.i3.81

Abstract

A 60-year-old male patient presented with jaundice and dark urine for three days, icteric sclerae and skin rash on his legs for six months. Laboratory investigations revealed an atypical cryoglobulinemia with high hepatitis C virus (HCV)-RNA levels. Imaging studies showed cholestasis was accompanying HCV. Capillary zone electrophoresis using immunosubtraction method revealed a polyclonal immunoglobulin G and immunoglobulin A (IgA) monoclonal cryoglobulin and that IgA lambda was absent in immunofixation electrophoresis. After a liver biopsy, chronic hepatitis C, HCV related mixed cryoglobulinemia and cryoglobulinemic vasculitis were diagnosed and antiviral therapy was initiated. Our HCV patient presented with cryoglobulinemic symptoms with an atypical cryoglobulinemia that was detected by an alternative method: Immunosubtraction by capillary electrophoresis. Different types of cryoglobulins may therefore have a correlation with clinical symptoms and prognosis. Therefore, the accurate immunotyping of cryoglobulins with alternative methods may provide more information about cryoglobulin-generated pathology.

Keywords: Cryoglobulinemia; Electrophoresis; Hepatitis C; Immunosubtraction; Immunotyping

References

  1. Clin Exp Immunol. 2003 Aug;133(2):153-5 - PubMed
  2. Clin Exp Immunol. 1971 Dec;9(6):795-807 - PubMed
  3. Z Gastroenterol. 1997 Oct;35(10):921-8 - PubMed
  4. Orphanet J Rare Dis. 2008 Sep 16;3:25 - PubMed
  5. Am J Gastroenterol. 2003 Nov;98(11):2568-9; author reply 2569-70 - PubMed
  6. Ann Clin Biochem. 2010 Jan;47(Pt 1):8-16 - PubMed
  7. World J Gastroenterol. 2014 Mar 21;20(11):2962-70 - PubMed
  8. Gastroenterol Clin Biol. 1994;18(3):251-6 - PubMed
  9. Am J Hematol. 2011 Jun;86(6):500-2 - PubMed
  10. World J Clin Cases. 2014 May 16;2(5):160-6 - PubMed
  11. J Clin Pathol. 2002 Jan;55(1):4-13 - PubMed
  12. Am J Clin Pathol. 2008 Mar;129(3):451-8 - PubMed
  13. Semin Arthritis Rheum. 2004 Jun;33(6):355-74 - PubMed
  14. Gastroenterol Hepatol (N Y). 2007 Sep;3(9):695-703 - PubMed
  15. Clin Chem. 2008 Jan;54(1):39-43 - PubMed
  16. Ann Clin Lab Sci. 2006 Autumn;36(4):395-408 - PubMed
  17. Clin Chem Lab Med. 2004;42(6):614-20 - PubMed
  18. Eur J Clin Invest. 1993 Jul;23(7):399-405 - PubMed
  19. J Immunol. 1992 Oct 1;149(7):2345-51 - PubMed
  20. Autoimmunity. 1989;2(2):155-64 - PubMed
  21. Arch Pathol Lab Med. 1999 Feb;123(2):119-25 - PubMed

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