CRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW

Description of two clinical cases of chronic HBV hepatitis at cirrhotic stage associated with type III cryoglobulinemia manifested with symptoms of systemic vasculitis is presented in current article. There were no signs of HCV infection in both patients. In first case cutaneous vasulitis appeared a...

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Autores principales:	N. V. Dunaeva, O. E. Nikitina, B. V. Stukov, V. E. Karev, A. V. Mazing, M. Y. Lerner, S. V. Lapin, Areg A. Totolian
Formato:	article
Lenguaje:	RU
Publicado:	Sankt-Peterburg : NIIÈM imeni Pastera 2014
Materias:	cryoglobulinemia cryoglobulinemic vasculitis hepatitis b treatment of cryoglobulinemic vasculitis Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/4d979aa609664579925f8a7eb53fbda8
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spelling	oai:doaj.org-article:4d979aa609664579925f8a7eb53fbda82021-11-22T07:09:47ZCRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW2220-76192313-739810.15789/2220-7619-2014-3-284-292https://doaj.org/article/4d979aa609664579925f8a7eb53fbda82014-08-01T00:00:00Zhttps://www.iimmun.ru/iimm/article/view/189https://doaj.org/toc/2220-7619https://doaj.org/toc/2313-7398Description of two clinical cases of chronic HBV hepatitis at cirrhotic stage associated with type III cryoglobulinemia manifested with symptoms of systemic vasculitis is presented in current article. There were no signs of HCV infection in both patients. In first case cutaneous vasulitis appeared after 19 years since serological finding of HBsAg and vasculitis progressed despite steroid therapy. Initiation of antiviral therapy (entecavir 0.5 g/day) induced transient remission. After interruption of antiviral therapy vasculitis reappeared with several vasculitic ulcers on lower legs. Mild improvement of vasculitis was noted after repeated plasmapheresis, steroid and cytostatic treatment with addition of lamivudin. Despite therapy reactivation of HBV infection was detected. Lamivudin was changed to entecavir and rituximab was given in two 500 mg infusions. Combined antiviral and anti-CD20 treatment induced remission of cutaneous vasculitis and healing of leg ulcers. In other case vasculitis manifested after 21 years since detection of HBsAg with cutaneous purpura, arthritis and microhematuria. Entecavir 0.5 g/day induced rapid virological response and complete remission of symptoms related to vasculitis. Similar literature cases were reviewed and available treatment options in refractory cryoglobulinemic vasculitis were discussed.N. V. DunaevaO. E. NikitinaB. V. StukovV. E. KarevA. V. MazingM. Y. LernerS. V. LapinAreg A. TotolianSankt-Peterburg : NIIÈM imeni Pasteraarticlecryoglobulinemiacryoglobulinemic vasculitishepatitis btreatment of cryoglobulinemic vasculitisInfectious and parasitic diseasesRC109-216RUInfekciâ i Immunitet, Vol 4, Iss 3, Pp 284-292 (2014)
institution	DOAJ
collection	DOAJ
language	RU
topic	cryoglobulinemia cryoglobulinemic vasculitis hepatitis b treatment of cryoglobulinemic vasculitis Infectious and parasitic diseases RC109-216
spellingShingle	cryoglobulinemia cryoglobulinemic vasculitis hepatitis b treatment of cryoglobulinemic vasculitis Infectious and parasitic diseases RC109-216 N. V. Dunaeva O. E. Nikitina B. V. Stukov V. E. Karev A. V. Mazing M. Y. Lerner S. V. Lapin Areg A. Totolian CRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW
description	Description of two clinical cases of chronic HBV hepatitis at cirrhotic stage associated with type III cryoglobulinemia manifested with symptoms of systemic vasculitis is presented in current article. There were no signs of HCV infection in both patients. In first case cutaneous vasulitis appeared after 19 years since serological finding of HBsAg and vasculitis progressed despite steroid therapy. Initiation of antiviral therapy (entecavir 0.5 g/day) induced transient remission. After interruption of antiviral therapy vasculitis reappeared with several vasculitic ulcers on lower legs. Mild improvement of vasculitis was noted after repeated plasmapheresis, steroid and cytostatic treatment with addition of lamivudin. Despite therapy reactivation of HBV infection was detected. Lamivudin was changed to entecavir and rituximab was given in two 500 mg infusions. Combined antiviral and anti-CD20 treatment induced remission of cutaneous vasculitis and healing of leg ulcers. In other case vasculitis manifested after 21 years since detection of HBsAg with cutaneous purpura, arthritis and microhematuria. Entecavir 0.5 g/day induced rapid virological response and complete remission of symptoms related to vasculitis. Similar literature cases were reviewed and available treatment options in refractory cryoglobulinemic vasculitis were discussed.
format	article
author	N. V. Dunaeva O. E. Nikitina B. V. Stukov V. E. Karev A. V. Mazing M. Y. Lerner S. V. Lapin Areg A. Totolian
author_facet	N. V. Dunaeva O. E. Nikitina B. V. Stukov V. E. Karev A. V. Mazing M. Y. Lerner S. V. Lapin Areg A. Totolian
author_sort	N. V. Dunaeva
title	CRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW
title_short	CRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW
title_full	CRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW
title_fullStr	CRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW
title_full_unstemmed	CRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW
title_sort	cryoglobulinemic vasculitis associated with hbv infection: clinical observations and literature review
publisher	Sankt-Peterburg : NIIÈM imeni Pastera
publishDate	2014
url	https://doaj.org/article/4d979aa609664579925f8a7eb53fbda8
work_keys_str_mv	AT nvdunaeva cryoglobulinemicvasculitisassociatedwithhbvinfectionclinicalobservationsandliteraturereview AT oenikitina cryoglobulinemicvasculitisassociatedwithhbvinfectionclinicalobservationsandliteraturereview AT bvstukov cryoglobulinemicvasculitisassociatedwithhbvinfectionclinicalobservationsandliteraturereview AT vekarev cryoglobulinemicvasculitisassociatedwithhbvinfectionclinicalobservationsandliteraturereview AT avmazing cryoglobulinemicvasculitisassociatedwithhbvinfectionclinicalobservationsandliteraturereview AT mylerner cryoglobulinemicvasculitisassociatedwithhbvinfectionclinicalobservationsandliteraturereview AT svlapin cryoglobulinemicvasculitisassociatedwithhbvinfectionclinicalobservationsandliteraturereview AT aregatotolian cryoglobulinemicvasculitisassociatedwithhbvinfectionclinicalobservationsandliteraturereview
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CRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW

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