The aim of this study was to evaluate the prevalence and the clinical profile of mixed crioglobulinemia (MC) in consecutive patients enrolled in PITER. A specific questionnaire regarding the presence of crioglobulinemia and related symptoms was applied. Of 7496 patients enrolled, the MC was never tested in 6019 (80%). The remaining 1477 HCV (+) patients were classified as follows: in 22% as symptomatic MC (MCS-HCV: mean age 64 ± 11 years), in 29% as asymptomatic MC (MC-HCV: mean age 61 ± 12 years), and in 49% as HCV infected patients without MC (mean age 60 ± 13 years). Among the 328 patients, declared to be “symptomatic”, detailed data that confirmed MCS were available for 252 (33% of patients with MC). MC symptoms included purpura, weakness, and arthralgia (MC triad), as well as peripheral neuropathy, siccasyndrome, myalgias, cutaneous ulcers and renal involvement. Nocturnal sweet, fever and pruritis was also rarely reported. In patients with MCS the liver fibrosis stage, was F0-F1 in 40%; F2 in 12%; F3 in 13% and F4 in 35% of patients, with no significant differences among the different groups. Previous IFN-based therapy was reported in 54% of MCS-HCV, in 45% of MC-HCV and in 50% of HCV patients. 162 (65%) of MCS-HCV patients have been treated or are on DAA treatment. Preliminary results are available showing high rate of virological and clinical response with rare (1%: 3 patients) treatment interruption due to adverse events/intolerance. In Conclusion: This nation-wide, in progress study showed that, in spite of the clinical and therapeutic importance of HCV related MC, the presence of this condition is not considered in the large majority of cases. Among patients with MC, a symptomatic form was observed in more than 30% of cases. Treated patients will be prospectively followed up to better characterize the long term outcome of this important consequence of chronic HCV infection.

HCV-related mixed cryoglobulinemia: Data from PITER, a nationwide Italian HCV cohort study

Gragnani L
2016-01-01

Abstract

The aim of this study was to evaluate the prevalence and the clinical profile of mixed crioglobulinemia (MC) in consecutive patients enrolled in PITER. A specific questionnaire regarding the presence of crioglobulinemia and related symptoms was applied. Of 7496 patients enrolled, the MC was never tested in 6019 (80%). The remaining 1477 HCV (+) patients were classified as follows: in 22% as symptomatic MC (MCS-HCV: mean age 64 ± 11 years), in 29% as asymptomatic MC (MC-HCV: mean age 61 ± 12 years), and in 49% as HCV infected patients without MC (mean age 60 ± 13 years). Among the 328 patients, declared to be “symptomatic”, detailed data that confirmed MCS were available for 252 (33% of patients with MC). MC symptoms included purpura, weakness, and arthralgia (MC triad), as well as peripheral neuropathy, siccasyndrome, myalgias, cutaneous ulcers and renal involvement. Nocturnal sweet, fever and pruritis was also rarely reported. In patients with MCS the liver fibrosis stage, was F0-F1 in 40%; F2 in 12%; F3 in 13% and F4 in 35% of patients, with no significant differences among the different groups. Previous IFN-based therapy was reported in 54% of MCS-HCV, in 45% of MC-HCV and in 50% of HCV patients. 162 (65%) of MCS-HCV patients have been treated or are on DAA treatment. Preliminary results are available showing high rate of virological and clinical response with rare (1%: 3 patients) treatment interruption due to adverse events/intolerance. In Conclusion: This nation-wide, in progress study showed that, in spite of the clinical and therapeutic importance of HCV related MC, the presence of this condition is not considered in the large majority of cases. Among patients with MC, a symptomatic form was observed in more than 30% of cases. Treated patients will be prospectively followed up to better characterize the long term outcome of this important consequence of chronic HCV infection.
https://www.dldjournalonline.com/article/S1590-8658(15)00741-0/fulltext
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/1163458
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