count in her blood steadily decreased, and by April of this year it was undetectable.
screen revealed mixed type 2 cryoglobulins
without rheumatoid factor activity (86 [micro]g/mL), suggesting the diagnosis of PUK in the context of HCVrelated cryoglobulinemia.
Additional laboratory findings often include anemia, elevated lactate dehydrogenase, hypergammaglobulinemia, and the presence of autoantibodies and immune complexes (e.g., positive Coombs test, cold agglutinins, cryoglobulins
, rheumatoid factor, and antismooth muscle antibodies) [1, 3, 4].
C3, C4, rheumatoid factor, anti- dsDNA, anti-smith, Anti-neutrophil cytoplasmic antibody, antitopoisomerase, anti-centromere, anti-Ro, anti-La, anti- RNP, anti-Jo1 and cryoglobulins
all were negative.
, hepatitis B virus or hepatitis C virus hepatitis, antistreptolysin O, several autoantibodies (including antinuclear antibodies, antineutrophil cytoplasmic autoantibody, anti-glomerular basement membrane antibody, and rheumatoid factor), and serum/urine immunofixation electrophoresis were all negative.
Although the pathophysiology of HCV-related PN is controversial, the deposition of HCV-RNA microparticles and cryoglobulins
, direct viral invasion, and perivascular mononuclear inflammation are all accused of the development of HCV-related vasculitic lesions (7,8,9,10).
and the levels of complement were analyzed in patients who had positive serologic tests for rheumatoid factor (RF).
Immunoloserological analysis (serum immunoglobulins, chamber count of eosinophils, antinuclear antibodies, complement components--Clq, C3, C4 and C1s inhibitor--qualitative and quantitative analyses, antineutrophil cytoplasmic antibodies, cryoglobulins
Authors noted that the presence of cryoglobulins
coincided with persistent arthralgias.
* Further tests to assist with the diagnosis include antinuclear antibody profile, antineutrophil cytoplasmic antibody, C-reactive protein, cryoglobulins
, serum complement, hepatitis B and C profile, HIV, venereal disease research laboratory test and uric acid levels.
Anticardiolipin auto antibodies in serum samples and cryoglobulins
of patients with chronic hepatitis C infection.
In addition, M-proteins, especially those that are also cryoglobulins
, can precipitate and cause erroneous measurements via several methods (1).