Purpura with ulcerative skin lesions and mixed cryoglobulinemia in a quiescent hepatitis B virus carrier.

Abstract

Mixed cryoglobulinemia is occasionally seen in patients with hepatitis B virus (HBV) infection. This report presents the case of a quiescent HBV carrier who had type II mixed cryoglobulinemia, protracted purpura, ulcerative skin lesions and advanced chronic kidney disease. The cutaneous manifestations of the patient improved along with a decrease in the serum cryoglobulin and HBV-deoxyribonucleic acid levels following the initiation of oral entecavir in combination with plasmapheresis. However, the patient ultimately required prednisolone due to the limited benefits of these treatments. We also discuss various concerns regarding steroid treatment in patients with mixed cryoglobulinemia complicated by HBV infection.

• Authors: Tomoyuki Yamazaki, Tetsu Akimoto, Kousuke Okuda, Taro Sugase, Eri Takeshima, Akihiko Numata, Yoshiyuki Morishita, Yoshitaka Iwazu, Hiromichi Yoshizawa, Takanori Komada, Kana Iwazu, Osamu Saito, Fumi Takemoto, Shigeaki Muto, Eiji Kusano
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 53 Issue 2 Pg. 115-9 ( 2014) ISSN: 1349-7235 [Electronic] Japan
• PMID: 24429450 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antiviral Agents
• Cryoglobulins
• DNA, Viral
• Hepatitis B Antibodies
• Hepatitis B Antigens
• entecavir
• Guanine
• Prednisolone

Topics

• Aged
• Antiviral Agents (therapeutic use)
• Combined Modality Therapy
• Cryoglobulinemia (blood, drug therapy, etiology)
• Cryoglobulins (analysis)
• DNA, Viral (blood)
• Female
• Guanine (analogs & derivatives, therapeutic use)
• Hepatitis B Antibodies (blood)
• Hepatitis B Antigens (blood)
• Hepatitis B, Chronic (blood, complications, drug therapy)
• Humans
• Plasmapheresis
• Prednisolone (therapeutic use)
• Purpura (etiology)
• Renal Insufficiency, Chronic (blood, complications)
• Skin Ulcer (etiology)