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Infeção crónica pelo vírus C da hepatite : crioglobulinemia mista tipo II biclonal, expressão rara da doença
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Identificado em 1989, o virus da hepatite C, inicialmente considerado como meramente responsavel por efeitos a nivel hepatico, e hoje visto como o agente principal no surgimento de um variado leque de patologias extra-hepaticas, podendo estas, muitas vezes, constituir a manifestacao inicial da infecao. Entre as manifestacoes extra-hepaticas mais comuns encontram-se as crioglobulinemias mistas de tipo II e do tipo III, caracterizadas pela presença em circulacao de crioglobulinas policlonais (tipo III) ou monoclonais (tipo II) e, quando sintomaticas, se manifestam atraves de um quadro de vasculite crioglobulinemica. Por vezes, em casos raros, sao detetados quadros de crioglobulinemias mistas com crioglobulinas que nao
se enquadram exclusivamente em nenhum dos tipos atras referidos e que poderao representar quadros evolutivos da poli para a monoclonalidade, sendo o mais raro a crioglobulinemia mista do tipo II biclonal, que se encontrava presente no caso clinico apresentado neste artigo.
Identified in 1989, hepatitis C virus, originally considered as merely responsible for effects in the liver, is now seen as the main agent in the emergence of a wide range of extra-hepatic diseases which, in some cases, can be the initial manifestation of the infection. Among the most common extra-hepatic manifestations are type II and type III mixed crioglobulinemias, characterized by the presence of circulating cryoglobulins either polyclonal (type III) or monoclonal (type II) and, when symptomatic, manifest themselves through a cryoglobulinemic vasculitis. Sometimes, in rare cases, one can detect mixed crioglobulinemias with cryoglobulins that do not fall exclusively in any of the aforementioned types, and may represent evolutionary intermediaries in the evolution form poly to monoclonality, being the rarest of them all type II biclonal mixed cryoglobulinemia, who was present in the clinical case which is the focus of this article.
Identified in 1989, hepatitis C virus, originally considered as merely responsible for effects in the liver, is now seen as the main agent in the emergence of a wide range of extra-hepatic diseases which, in some cases, can be the initial manifestation of the infection. Among the most common extra-hepatic manifestations are type II and type III mixed crioglobulinemias, characterized by the presence of circulating cryoglobulins either polyclonal (type III) or monoclonal (type II) and, when symptomatic, manifest themselves through a cryoglobulinemic vasculitis. Sometimes, in rare cases, one can detect mixed crioglobulinemias with cryoglobulins that do not fall exclusively in any of the aforementioned types, and may represent evolutionary intermediaries in the evolution form poly to monoclonality, being the rarest of them all type II biclonal mixed cryoglobulinemia, who was present in the clinical case which is the focus of this article.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Hepatite C Hepacivirus Hepatite C crónica Crioglobulinemia