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Low-grade malignant lymphoma, hepatitis C virus infection, and mixed
cryoglobulinemia
G Pozzato, C Mazzaro, M Crovatto, ML Modolo, S Ceselli, G Mazzi, S Sulfaro, F Franzin, P Tulissi and M Moretti
First Department of Medicine, Pordenone General Hospital, Trieste, Italy.
Because a close relationship has been established between mixed
cryoglobulinemia and hepatitis C virus (HCV) infection, the clinical,
histologic, and virologic findings of 31 patients affected by mixed
cryoglobulinemia have been determined. HCV infection was investigated by
the presence of anti-HCV antibodies and by polymerase chain reaction (PCR)
amplification of the 5' untranslated region (5'UTR), and the genotype of
HCV was also determined according to Okamoto et al (J Gen Virol 73:673,
1992). A bone marrow (BM) biopsy was performed in all patients, and liver
and kidney biopsies were performed when indicated. The prevalence of
anti-HCV antibodies was high (83.9%); polymerase chain reaction
amplification of the 5' untranslated region was positive in 26 subjects
(83.9%), and Core region amplification in 26 of 27 subjects (96.2%). A high
prevalence of genotype II was found (76.6%). Chronic liver disease was
present in 15 (48%) patients. BM biopsy specimens showed the presence of
low-grade non-Hodgkin's lymphomas in 12 cases (38.7%), whereas, in 11
patients (35.5%), the BM infiltration was not monoclonal (reactive). Mixed
cryoglobulinemia is closely associated with HCV infection. Apparently, only
1 patient was not infected by the virus. Several HCV genotypes are involved
in the pathogenesis of mixed cryoglobulinemia. The disease is associated
with a high prevalence of low-grade non-Hodgkin's lymphomas.
Volume 84,
Issue 9,
pp. 3047-3053,
11/01/1994
Copyright © 1994 by The American Society of Hematology
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