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Cryoglobulinemia vasculitis is a small-vessel systemic vasculitis.1 The most common type is mixed cryoglobulinemia (MC), which is associated with hepatitis C virus (HCV), although autoimmune disorders such as systemic lupus erythematosus, primary Sjögren's syndrome or rheumatoid arthritis have also been described with MC.
A 51-year-old man had a diagnosis of anti-cyclic citrullinated peptide antibodies (anti-CCP) positive non-erosive rheumatoid arthritis in 2006 without cryoglobulinemia, and the disease was well controlled using leflunomide. Since April 2010, asthenia, muscular pain, arthralgias and bilateral foot paresthesias occurred. There was a presence of purpura with bilateral hypoesthesia in the common fibular nerve territory (left first toe levator weakness at 2/5), but no joint swelling. C-reactive protein and fibrinogen were …
Ethics approval consent form was obtained from the patient and was approved by the local commitee of the drug therapy.
Competing interests No, there are no competing interests
Provenance and peer review Not commissioned; externally peer reviewed
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