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Erschienen in: Der Internist 3/2008

01.03.2008 | Schwerpunkt

Hepatitis-assoziierte Kryoglobulinämie

verfasst von: S. Pischke, M. Cornberg, Prof. Dr. M.P. Manns

Erschienen in: Die Innere Medizin | Ausgabe 3/2008

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Zusammenfassung

Kryoglobuline sind Immunglobuline, die bei Temperaturen unter 37°C präzipitieren. Klinisch manifestiert sich eine Kryoglobulinämie mit sehr unterschiedlichen Symptomen an diversen Organen. Die klinisch bedeutendsten Symptome sind Fatigue, periphere Polyneuropathie und vaskulitisassoziierte Hautdefekte. Pathophysiologisch beruht eine Kryoglobulinämie auf einer gestörten Immunkaskade mit einer gesteigerten B-Zell-Aktivität. Der oftmals beobachtete Übergang einer Kryoglobulinämie in ein malignes Non-Hodgkin-Lymphom ist fließend. Die Assoziation zwischen Kryoglobulinämie und Virushepatitis ist am größten bei der Hepatitis-C-Virusinfektion. Andere Ursachen einer Kryoglobulinämie sind rheumatische und hämatologische Erkrankungen. Während früher v. a. mit Plasmapherese und Immunsuppression therapiert wurde, hat sich, durch die hohe Korrelation mit einer HCV-Infektion, die Bedeutung antiviraler Therapien im Rahmen von Kryoglobulinämien herausgestellt. Fälle von rascher Verschlechterung unter Interferon α wurden jedoch auch beobachtet. Eine vielversprechende alternative Therapieoption ist der Einsatz von Rituximab.
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Metadaten
Titel
Hepatitis-assoziierte Kryoglobulinämie
verfasst von
S. Pischke
M. Cornberg
Prof. Dr. M.P. Manns
Publikationsdatum
01.03.2008
Verlag
Springer-Verlag
Erschienen in
Die Innere Medizin / Ausgabe 3/2008
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI
https://doi.org/10.1007/s00108-007-2014-7

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