Cacoub P, Musset L, Lunel Fabiani F, Perrin M, Leger J M, Thi Huong Du L, Wechsler B, Bletry O, Opolon P, Huraux J M
Department of Internal Medicine, Hôpital Pitié-Salpêtrière, Paris, France.
Br J Rheumatol. 1993 Aug;32(8):689-92. doi: 10.1093/rheumatology/32.8.689.
Clinical and laboratory evidence of liver involvement are frequently found in essential mixed cryoglobulinaemia (EMC). We looked for evidence of hepatitis C virus (HCV) infection in 37 patients with EMC. Anti-HCV antibodies (Ab) were found in 16/37 (43%) patients with EMC using the ELISA 2 test and the RIBA 2 test. The 16 anti-HCV-Ab positive patients (group 1) were compared to the 21 anti-HCV-Ab negative patients (group 2). Group 1 patients had more frequent cutaneous involvement (P = 0.02), clinical, biological and histologic hepatic involvement (P < 0.01), higher serum cryoglobulin and lower CH50 levels (P < 0.001). Serum hepatitis B virus markers were infrequent in both groups and no patient from either group had detectable serum HBV DNA. These preliminary results suggest that HCV may be another cause of mixed cryoglobulinaemia.
在原发性混合性冷球蛋白血症（EMC）中，经常会发现肝脏受累的临床和实验室证据。我们对37例EMC患者进行了丙型肝炎病毒（HCV）感染证据的筛查。采用酶联免疫吸附试验2（ELISA 2）和重组免疫印迹法2（RIBA 2）检测，在37例EMC患者中有16例（43%）检测到抗HCV抗体（Ab）。将16例抗HCV-Ab阳性患者（第1组）与21例抗HCV-Ab阴性患者（第2组）进行比较。第1组患者皮肤受累更为频繁（P = 0.02），临床、生物学和组织学肝脏受累情况更为常见（P < 0.01），血清冷球蛋白水平更高而总补体活性（CH50）水平更低（P < 0.001）。两组患者血清乙肝病毒标志物均不常见，两组中均无患者血清HBV DNA可检测到。这些初步结果表明，HCV可能是混合性冷球蛋白血症的另一个病因。
