Purpura with Ulcerative Skin Lesions and Mixed Cryoglobulinemia in a Quiescent Hepatitis B Virus Carrier

Tomoyuki Yamazaki; Tetsu Akimoto; Kousuke Okuda; Taro Sugase; Eri Takeshima; Akihiko Numata; Yoshiyuki Morishita; Yoshitaka Iwazu; Hiromichi Yoshizawa; Takanori Komada; Kana Iwazu; Osamu Saito; Fumi Takemoto; Shigeaki Muto; Eiji Kusano

doi:10.2169/internalmedicine.53.1203

CASE REPORTS

Purpura with Ulcerative Skin Lesions and Mixed Cryoglobulinemia in a Quiescent Hepatitis B Virus Carrier

Tomoyuki Yamazaki, Tetsu Akimoto, Kousuke Okuda, Taro Sugase, Eri Takeshima, Akihiko Numata, Yoshiyuki Morishita, Yoshitaka Iwazu, Hiromichi Yoshizawa, Takanori Komada, Kana Iwazu, Osamu Saito, Fumi Takemoto, Shigeaki Muto, Eiji Kusano

著者情報

Tomoyuki Yamazaki
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Tetsu Akimoto
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Kousuke Okuda
Okuda Clinic, Japan
Taro Sugase
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Okuda Clinic, Japan
Eri Takeshima
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Akihiko Numata
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Yoshiyuki Morishita
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Yoshitaka Iwazu
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Hiromichi Yoshizawa
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Takanori Komada
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Kana Iwazu
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Osamu Saito
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Fumi Takemoto
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Shigeaki Muto
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan
Eiji Kusano
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan

キーワード: purpura, mixed cryoglobulinemia, hepatitis B, entecavir, reactivation

ジャーナルオープンアクセス

2014 年 53 巻 2 号 p. 115-119

DOI https://doi.org/10.2169/internalmedicine.53.1203

詳細

抄録

Mixed cryoglobulinemia is occasionally seen in patients with hepatitis B virus (HBV) infection. This report presents the case of a quiescent HBV carrier who had type II mixed cryoglobulinemia, protracted purpura, ulcerative skin lesions and advanced chronic kidney disease. The cutaneous manifestations of the patient improved along with a decrease in the serum cryoglobulin and HBV-deoxyribonucleic acid levels following the initiation of oral entecavir in combination with plasmapheresis. However, the patient ultimately required prednisolone due to the limited benefits of these treatments. We also discuss various concerns regarding steroid treatment in patients with mixed cryoglobulinemia complicated by HBV infection.

責任著者(Corresponding author)

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