DeBiase Charles J, Stacey Stephen K, LaBaere Richard J
Family Medicine, A.T. Still University Kirksville College of Osteopathic Medicine, Kirksville, USA.
Family Medicine, Mayo Clinic Health System, La Crosse, USA.
Cureus. 2025 Mar 13;17(3):e80521. doi: 10.7759/cureus.80521. eCollection 2025 Mar.
This report presents the case of a 34-year-old female with chronic cholecystitis and hepatic failure due to alcohol use and hepatitis C. She also has a history of opioid and alcohol use disorders. Frequent hospitalizations for fluid overload culminated in her presentation with lower extremity swelling and palpable purpura. Investigation revealed leukocytoclastic vasculitis, initially raising concern for mixed cryoglobulinemia from hepatitis C but ultimately more likely due to drug-induced vasculitis. This case highlights the diagnostic challenge of differentiating between hepatitis C-associated mixed cryoglobulinemia and drug-induced vasculitis, emphasizing the need for thorough evaluation to guide appropriate management.
本报告介绍了一名34岁女性的病例，该患者因饮酒和丙型肝炎患有慢性胆囊炎和肝衰竭。她还有阿片类药物和酒精使用障碍史。因液体超负荷频繁住院，最终导致她出现下肢肿胀和可触及的紫癜。检查发现白细胞破碎性血管炎，最初怀疑是丙型肝炎引起的混合性冷球蛋白血症，但最终更可能是药物性血管炎。该病例突出了区分丙型肝炎相关混合性冷球蛋白血症和药物性血管炎的诊断挑战，强调了进行全面评估以指导适当治疗的必要性。
