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10.1016/j.jaut.2015.08.008

http://scihub22266oqcxt.onion/10.1016/j.jaut.2015.08.008
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26320984!ä!26320984

suck abstract from ncbi


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pmid26320984      J+Autoimmun 2015 ; 65 (ä): 74-81
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  • Non HCV-related infectious cryoglobulinemia vasculitis: Results from the French nationwide CryoVas survey and systematic review of the literature #MMPMID26320984
  • Terrier B; Marie I; Lacraz A; Belenotti P; Bonnet F; Chiche L; Graffin B; Hot A; Kahn JE; Michel C; Quemeneur T; de Saint-Martin L; Hermine O; Leger JM; Mariette X; Senet P; Plaisier E; Cacoub P
  • J Autoimmun 2015[Dec]; 65 (ä): 74-81 PMID26320984show ga
  • In patients with infectious cryoglobulinemia vasculitis (CryoVas) in the absence of hepatitis C virus infection, data on presentation, therapeutic management and outcome are lacking. We conducted a nationwide survey that included patients with HCV-negative CryoVas. We describe here the presentation, therapeutic management and outcome of 18 patients with non-HCV infectious CryoVas and 27 additional patients identified form a systematic review of the literature. We included 18 patients, mean age 57.9+/-13.5 years. Infectious causes were viral infections in 8 patients [hepatitis B virus (HBV) in 4, and cytomegalovirus, Epstein Barr virus, parvovirus B19 and human immunodeficiency virus in one case each], pyogenic bacterial infection in 6 patients, parasitic infection in 2 patients, and leprosy and candidiasis in one case each. Baseline manifestations were purpura (78%), glomerulonephritis (28%), arthralgia (28%), peripheral neuropathy (22%), skin necrosis (22%), cutaneous ulcers (17%), and myalgia (11%). Cryoglobulinemia was type II in 2/3 of cases. Most cases received specific anti-infectious therapy as first-line therapy, sometimes associated with corticosteroids, achieving sustained remission in the majority of cases. Refractory or relapsing patients, frequently related to HBV infection, showed a complete remission after rituximab in addition to antiviral therapy. In contrast, corticosteroids and/or immunosuppressive agents used in the absence of anti-infectious agents were frequently associated with refractory CryoVas. Viral and pyogenic bacterial infections represent the main causes of non-HCV infectious CryoVas. Antimicrobial therapy is commonly associated with sustained remission. Immunosuppressive agents should be considered only as a second-line option in patients with refractory vasculitis.
  • |*Cryoglobulinemia/diagnosis/drug therapy/microbiology[MESH]
  • |*Systemic Vasculitis/diagnosis/drug therapy/microbiology[MESH]
  • |Adrenal Cortex Hormones/*therapeutic use[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Anti-Infective Agents/therapeutic use[MESH]
  • |Bacterial Infections/complications[MESH]
  • |Cytomegalovirus Infections/complications[MESH]
  • |Epstein-Barr Virus Infections/complications[MESH]
  • |Female[MESH]
  • |France/epidemiology[MESH]
  • |Hepatitis B/complications[MESH]
  • |Humans[MESH]
  • |Immunosuppressive Agents/therapeutic use[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Prognosis[MESH]
  • |Recurrence[MESH]
  • |Remission Induction[MESH]
  • |Rituximab/therapeutic use[MESH]
  • |Surveys and Questionnaires[MESH]


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