Bethlen S, Chandrikakumari K, Leval L, Giot J, Mukeba D, Leonard P, Frippiat F, Meuris C, Delwaide J, Moutschen M. Chronic hepatitis C infection in a patient with bone marrow hypoplasia. World J Gastroenterol 2008; 14(26): 4238-4240 [PMID: 18636673 DOI: 10.3748/wjg.14.4238]
Corresponding Author of This Article
Kavitha Chandrikakumari, MD, Department of Infectious Diseases and Internal Medicine, Centre Hospitalier Universitaire de Liege, Service des Maladies Infectieuses et Medecine Interne, CHU, B35, Domaine du Sart-Tilman 4000, Belgium. drchandrika@gmail.com
Article-Type of This Article
Case Report
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World J Gastroenterol. Jul 14, 2008; 14(26): 4238-4240 Published online Jul 14, 2008. doi: 10.3748/wjg.14.4238
Chronic hepatitis C infection in a patient with bone marrow hypoplasia
S Bethlen, K Chandrikakumari, L de Leval, JB Giot, D Mukeba, P Leonard, F Frippiat, C Meuris, J Delwaide, M Moutschen
S Bethlen, Medical Student, Centre Hospitalier Universitaire de Liege, Liege 4000, Belgium
K Chandrikakumari, JB Giot, D Mukeba, P Leonard, F Frippiat, C Meuris, M Moutschen, Department of Infectious Diseases and Internal Medicine, Centre Hospitalier Universitaire de Liege, Liege 4000, Belgium
L de Leval, Department of Pathology, Centre Hospitalier Universitaire de Liege, Liege 4000, Belgium
J Delwaide, Department of Gastroenterology and Hepatology, Centre Hospitalier Universitaire de Liege, Liege 4000, Belgium
Author contributions: Bethlen S collected the data about the patient; Chandrikakumari K wrote the article; Giot JB, Mukeba D, Leonard P and Meuris C followed up the patient; Delwaide J performed fibroscan and fibrotest; Moutschen M and Frippiat F reviewed the article; de Leval L performed PCR of the bone marrow biopsy and genetic analysis.
Correspondence to: Kavitha Chandrikakumari, MD, Department of Infectious Diseases and Internal Medicine, Centre Hospitalier Universitaire de Liege, Service des Maladies Infectieuses et Medecine Interne, CHU, B35, Domaine du Sart-Tilman 4000, Belgium. drchandrika@gmail.com
Telephone: +32-43667670
Fax: +32-43668583
Received: February 15, 2008 Revised: May 30, 2008 Accepted: June 6, 2008 Published online: July 14, 2008
Abstract
Chronic hepatitis C virus (HCV) infection is associated with multifarious extra-hepatic manifestations; the most described and discussed being mixed cryoglobulinemia which is strongly related to B-cell lymphoproliferative disorders (LPDs). We present a case of chronic HCV infection and mixed cryoglobulinemia, with minimal liver involvement. The case is a 53-year-old patient who was diagnosed as having bone marrow hypoplasia at the age of three. She received several blood transfusions to normalize her haemoglobin. At the age of 31, she was diagnosed with rheumatoid arthritis on account of her diffuse joint pain and inflammation, elevated rheumatoid factor (RF) and Raynaud’s phenomenon. Twenty years later, monoclonal gammopathy of IgG Lambda (one year later, changed to IgM Kappa) was detected during a routine examination. A bone marrow biopsy showed hypoplasia, Kappa positive B-lymphocytes and low-grade malignant lymphoma cells. PCR of the bone marrow aspirate was not contributory. No treatment was initiated owing to her poor bone marrow function and she is under regular follow-up.
