Remission of Hepatitis B Virus–Related Cryoglobulinemic Vasculitis with Entecavir

LettersDecember 16, 2008Remission of Hepatitis B Virus–Related Cryoglobulinemic Vasculitis with EntecavirTamihiro Kawakami, MD, PhD, Shiho Ooka, MD, PhD, Masako Mizoguchi, MD, PhD, Yoshinao Soma, MD, PhD, and Masahide Yamazaki, MD, PhDTamihiro Kawakami, MD, PhDFrom St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan, and Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan., Shiho Ooka, MD, PhDFrom St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan, and Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan., Masako Mizoguchi, MD, PhDFrom St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan, and Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan., Yoshinao Soma, MD, PhDFrom St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan, and Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan., and Masahide Yamazaki, MD, PhDFrom St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan, and Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-12-200812160-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Cryoglobulins are cold-precipitating immunoglobulins that persist in the serum and resolubilize when rewarmed. Cryoglobulinemic vasculitis is thought to result from the deposition of cryoglobulins on the vessel wall, which activates and mediates this damage. Cryoglobulinemic vasculitis has been well described in chronic hepatitis B and C infection. Entecavir, an analogue of 2′-deoxyguanosine, is converted intracellularly to an active 5′-triphosphate form that inhibits hepatitis B virus (HBV) polymerase (1). Entecavir exhibits potent antiviral activity in patients with chronic HBV infection.Objective: To describe a case of chronic HBV infection–related cryoglobulinemic vasculitis that responded to entecavir treatment.Case Report: A 57-year-old ...References1. McMahon MA, Jilek BL, Brennan TP, Shen L, Zhou Y, Wind-Rotolo M, et al. The HBV drug entecavir - effects on HIV-1 replication and resistance. N Engl J Med. 2007;356:2614-21. [PMID: 17582071] CrossrefMedlineGoogle Scholar2. Vanlandschoot P, Van Houtte F, Roobrouck A, Farhoudi A, Stelter F, Peterson DL, et al. LPS-binding protein and CD14-dependent attachment of hepatitis B surface antigen to monocytes is determined by the phospholipid moiety of the particles. J Gen Virol. 2002;83:2279-89. [PMID: 12185283] CrossrefMedlineGoogle Scholar3. D'Agnillo P, Levine JS, Subang R, and Rauch J. Prothrombin binds to the surface of apoptotic, but not viable, cells and serves as a target of lupus anticoagulant autoantibodies. J Immunol. 2003;170:3408-22. [PMID: 12626602] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Tamihiro Kawakami, MD, PhD; Shiho Ooka, MD, PhD; Masako Mizoguchi, MD, PhD; Yoshinao Soma, MD, PhD; Masahide Yamazaki, MD, PhDAffiliations: From St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan, and Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics December 16, 2008Volume 149, Issue 12Page: 911-912KeywordsAnticoagulantsAntigensAutoantibodiesBiopsyCellsChronic hepatitisChronic hepatitis BDNAElectromyographyHepatitis BHepatitis B virusHepatocytesImmunofluorescenceLesionsLiverNervesPolymerasesRashesUltrasound imagingVasculitis ePublished: 16 December 2008 Issue Published: December 16, 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...