Pérez Sánchez I, Rivera Redondo J, García Monforte A, Mayoayo Crespo M, Escudero Soto A, Pintado Cros T
Haematologica. 1998 Oct;83(10):946-8.
A cohort of 148 consecutive patients with hepatitis C virus infection were studied at the rheumatology out-patient clinic of a tertiary care teaching hospital. The diagnosis of hepatitis C virus infection was supported by detection of HCV RNA in the serum. Cryoglobulin screening was done in all patients and the presence of a monoclonal component was investigated when the cryocrit was higher than 1%. Patients with lymphoproliferative disorders were further investigated. Four patients had a B lymphoproliferative disorder, which represents a prevalence of 2.7% in this cohort of patients with hepatitis C virus infection. Mixed cryoglobulinemia (MC), with cryocrit higher than 1%, was found in 16 of 148 patients (11%). It was type III MC in 13 patients and type II MC in 3. All patients who developed a B lymphoproliferative disorder had mixed cryoglobulinemia, with a monoclonal component (type II MC) in two patients and without a monoclonal component (type III MC) in the other two. The incidence of B-lymphoproliferative disorders among this cohort of patients with hepatitis C virus infection seems to be significantly increased. However, the high frequency of asymptomatic, undiagnosed HCV infection among the apparently healthy general population may decrease the true significance of this association. Systematic screening of cryoglobulin production in patients with hepatitis C virus infection might clarify whether the risk of B lymphoproliferative disorders increases when type II or type III mixed cryoglobulinemia is present.
在一家三级护理教学医院的风湿病门诊，对148例连续的丙型肝炎病毒感染患者进行了研究。血清中检测到HCV RNA支持丙型肝炎病毒感染的诊断。对所有患者进行了冷球蛋白筛查，当冷沉淀比容高于1%时，对单克隆成分的存在进行了调查。对淋巴增殖性疾病患者进行了进一步调查。4例患者患有B淋巴细胞增殖性疾病，在这组丙型肝炎病毒感染患者中的患病率为2.7%。148例患者中有16例（11%）发现冷沉淀比容高于1%的混合性冷球蛋白血症（MC）。其中13例为III型MC，3例为II型MC。所有发生B淋巴细胞增殖性疾病的患者均有混合性冷球蛋白血症，2例患者有单克隆成分（II型MC），另外2例患者无单克隆成分（III型MC）。这组丙型肝炎病毒感染患者中B淋巴细胞增殖性疾病的发生率似乎显著增加。然而，在表面健康的普通人群中无症状、未诊断的HCV感染的高频率可能会降低这种关联的真正意义。对丙型肝炎病毒感染患者的冷球蛋白产生进行系统筛查可能会阐明，当存在II型或III型混合性冷球蛋白血症时，B淋巴细胞增殖性疾病的风险是否会增加。
