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Hepatitis C
What can be done about chronic Hep C and cryogloblinemia ( where the legs turn purplish and have lesions?
Hi I tried to respond to your first post but there was a glitch and no place to respond
Before treating I had the cyro and the rd dots on my legs had become purple lesions that left behind horrible brown places. My doc said the only way to get rid of it was to treat the HCV
Since finishing tx for HCV the cyro's are gone and in fact my legs are clearing up
I had been told the brown places were iron stains that would never go away. Well, they are going away. Also the spider angiomas are going away. Thank God, I was starting to get one on my cheek, it is now fading. What a nightmare to have all these spots to contend with
Good luck to you
Before treating I had the cyro and the rd dots on my legs had become purple lesions that left behind horrible brown places. My doc said the only way to get rid of it was to treat the HCV
Since finishing tx for HCV the cyro's are gone and in fact my legs are clearing up
I had been told the brown places were iron stains that would never go away. Well, they are going away. Also the spider angiomas are going away. Thank God, I was starting to get one on my cheek, it is now fading. What a nightmare to have all these spots to contend with
Good luck to you
Treatment
Treatment of mild or moderate cryoglobulinemia depends on the underlying cause. Treating the cause will often treat the cryoglobulinemia.
Mild cases can be treated by avoiding cold temperatures.
Standard hepatitis C treatments usually work for patients who have hepatitis C and mild or moderate cryoglobulinemia. However, the condition can return when treatment stops.
Severe cryoglobulinemia (involves vital organs or large areas of skin) is treated with corticosteroids and other medications that suppress the immune system.
Treatment may also involve plasmapheresis. Plasmapheresis is a procedure in which blood plasma is removed from the circulation and replaced by fluid, protein, or donated plasma.
Treatment of mild or moderate cryoglobulinemia depends on the underlying cause. Treating the cause will often treat the cryoglobulinemia.
Mild cases can be treated by avoiding cold temperatures.
Standard hepatitis C treatments usually work for patients who have hepatitis C and mild or moderate cryoglobulinemia. However, the condition can return when treatment stops.
Severe cryoglobulinemia (involves vital organs or large areas of skin) is treated with corticosteroids and other medications that suppress the immune system.
Treatment may also involve plasmapheresis. Plasmapheresis is a procedure in which blood plasma is removed from the circulation and replaced by fluid, protein, or donated plasma.
Hi Kookie
The goal of therapy is to treat underlying conditions, as well as to limit the precipitant cryoglobulin and the resultant inflammatory effects.[39] Thus, HCV testing is required. HCV-antibody or HCV-RNA testing may be diagnostic. If HCV test results are negative and clinical suspicion remains high, these tests may be performed on the cryoprecipitate. Asymptomatic cryoglobulinemia does not require treatment. Some authors recommend intervening as little as possible except when faced with severe deterioration of renal or neurologic function. Secondary cryoglobulinemia is best managed with treatment of the underlying malignancy or associated disease. Otherwise, cryoglobulinemia is treated simply with suppression of the immune response. A paucity of controlled studies evaluating the relative efficacy of various therapies limits the use of existing data.
Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used in patients with arthralgia and fatigue.
Immunosuppressive medications (eg, corticosteroid therapy and/or cyclophosphamide or azathioprine) are indicated upon evidence of organ involvement such as vasculitis, renal disease, progressive neurologic findings, or disabling skin manifestations.
Plasmapheresis is indicated for severe or life-threatening complications related to in vivo cryoprecipitation or serum hyperviscosity. Concomitant use of high-dose corticosteroids and cytotoxic agents is recommended for reduction of immunoglobulin production. Some authors recommend using concomitant cytotoxic medications or corticosteroids to reduce a rebound phenomenon that may develop after plasmapheresis.
Pegylated interferon alfa (IFN-alfa) combined with ribavirin has demonstrated efficacy in patients with cryoglobulinemia associated with hepatitis C, and efficacy in patients with chronic myelogenous leukemias and low-grade lymphomas has been reported. The details of therapy and the recommended approach vary based on the clinical setting, and expert opinion should be sought.[40]
Case reports have detailed the remission of hepatitis B–related cryoglobulinemic vasculitis with entecavir therapy.[41]
Small and uncontrolled studies suggest the anti-CD20 chimeric monoclonal antibody rituximab is effective in controlling disease manifestations such as vasculitis, peripheral neuropathy, arthralgias, low-grade B-cell lymphomas, renal disease, and fever.[42, 43] Rituximab therapy has been used predominately in HCV-related mixed cryoglobulinemia refractory to or unsuitable for corticosteroids and antiviral (IFN-alfa) therapy. Rituximab therapy is reportedly well tolerated in this patient population; however, treatment results in increased titers of HCV-RNA of undetermined significance. The National Institutes of Health has launched a large trial of rituximab in the treatment of mixed cryoglobulinemia.
from http://emedicine.medscape.com/article/329255-treatment
The goal of therapy is to treat underlying conditions, as well as to limit the precipitant cryoglobulin and the resultant inflammatory effects.[39] Thus, HCV testing is required. HCV-antibody or HCV-RNA testing may be diagnostic. If HCV test results are negative and clinical suspicion remains high, these tests may be performed on the cryoprecipitate. Asymptomatic cryoglobulinemia does not require treatment. Some authors recommend intervening as little as possible except when faced with severe deterioration of renal or neurologic function. Secondary cryoglobulinemia is best managed with treatment of the underlying malignancy or associated disease. Otherwise, cryoglobulinemia is treated simply with suppression of the immune response. A paucity of controlled studies evaluating the relative efficacy of various therapies limits the use of existing data.
Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used in patients with arthralgia and fatigue.
Immunosuppressive medications (eg, corticosteroid therapy and/or cyclophosphamide or azathioprine) are indicated upon evidence of organ involvement such as vasculitis, renal disease, progressive neurologic findings, or disabling skin manifestations.
Plasmapheresis is indicated for severe or life-threatening complications related to in vivo cryoprecipitation or serum hyperviscosity. Concomitant use of high-dose corticosteroids and cytotoxic agents is recommended for reduction of immunoglobulin production. Some authors recommend using concomitant cytotoxic medications or corticosteroids to reduce a rebound phenomenon that may develop after plasmapheresis.
Pegylated interferon alfa (IFN-alfa) combined with ribavirin has demonstrated efficacy in patients with cryoglobulinemia associated with hepatitis C, and efficacy in patients with chronic myelogenous leukemias and low-grade lymphomas has been reported. The details of therapy and the recommended approach vary based on the clinical setting, and expert opinion should be sought.[40]
Case reports have detailed the remission of hepatitis B–related cryoglobulinemic vasculitis with entecavir therapy.[41]
Small and uncontrolled studies suggest the anti-CD20 chimeric monoclonal antibody rituximab is effective in controlling disease manifestations such as vasculitis, peripheral neuropathy, arthralgias, low-grade B-cell lymphomas, renal disease, and fever.[42, 43] Rituximab therapy has been used predominately in HCV-related mixed cryoglobulinemia refractory to or unsuitable for corticosteroids and antiviral (IFN-alfa) therapy. Rituximab therapy is reportedly well tolerated in this patient population; however, treatment results in increased titers of HCV-RNA of undetermined significance. The National Institutes of Health has launched a large trial of rituximab in the treatment of mixed cryoglobulinemia.
from http://emedicine.medscape.com/article/329255-treatment
I have a lot of water pretension in my ankles and lower legs - one time so bad that it caused my skin to split - very painful. I take a medication for that now and am on a low salt diet.
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