Cryoglobulinaemia in hepatitis C-positive patients in Iran

Owlia MB, Sami R, Akhondi M, Salimzadeh A
Correspondence: Dr Mohammad Bagher Owlia, mbowlia2@yahoo.com; owlia@ssu.ac.ir

ABSTRACT
Introduction Cryoglobulins are found in a wide spectrum of disorders but are often transient and without clinical implications. The so-called essential mixed cryoglobulinaemia shows a striking association with hepatitis C virus (HCV) infection (greater than 90 percent). Type II cryoglobulinaemia is the major extrahepatic manifestation of HCV infection. This study aims to investigate the frequency of cryoglobulinaemia in HCV-positive patients in central Iran.
Methods 50 HCV-positive patients referred to the Shaheed Sadoughi Hospital in Yazd, Iran from May 2004 to December 2005, were included in the study. Their sera were assessed for cryoglobulins. The sera were separated by centrifugation at 37 degrees Celsius and placed in a four degrees Celsius refrigerator in two tubes, one simple and the other, a Wintrobe tube, to see if precipitation occurs during a 48-hour up to a seven-day period.
Results In this study, 50 HCV positive patients were evaluated. Only two patients were female. Mean age was 32 years (ranging from 17 to 52 years). In eight patients, the cryoglobulin test was positive. In seven patients, the test became positive less than 72 hours after sampling. Only one patient who was positive for cryoglobulinaemia, had clinical manifestation of frank vasculitis.
Conclusion The prevalence of cryoglobulinaemia in Iran may be lower than other areas, and it may be due to a higher prevalence of cryoglobulinaemia in females and lower prevalence of cryoglobulinaemia in HCV genotype-1a. Most of the cases in our study were male and the more prevalent genotype in Iran is genotype-1a.

Keywords: cryoglobulinaemia, hepatitis C, vasculitis
Singapore Med J 2007; 48(12): 1136–1139