Influence of inherited and acquired thrombophilic defects on the clinical manifestations of mixed cryoglobulinaemia.
Rheumatology (Oxford)
; 47(11): 1659-63, 2008 Nov.
Article
em En
| MEDLINE
| ID: mdl-18713771
ABSTRACT
OBJECTIVE:
To investigate the contribution of inherited and acquired thrombophilic defects to the clinical manifestations of mixed cryoglobulinaemia vasculitis.METHODS:
The following thrombophilic defects were investigated in 64 consecutive patients with HCV-associated mixed cryoglobulinaemia aPLs, lupus anti-coagulant, homocysteinaemia, protein C and protein S concentrations, activated protein C resistance, plasminogen activator inhibitor-1 4G4G and 5G5G genotypes, and the presence of mutations of factor V (Leiden and H1299R), of prothrombin (G20210A) and of methyl tetrahydrofolate reductase (C677T and A1298C). Additional variables were demographic data, duration of the disease, cryocrit level and vascular risk factors (diabetes, hypertension, hypercholesterolaemia and smoking habit). The following clinical manifestations of mixed cryoglobulinaemia were analysed as dependent covariates severity of purpura, presence of necrotic skin ulcers, presence of peripheral neuropathy and presence of kidney disease.RESULTS:
Logistic regression analysis identified hyperhomocysteinaemia as a risk factor for severe purpura (P < 0.0001) and for the presence of skin ulcers (P < 0.0001), whereas none of the other thrombophilic defects influenced the clinical presentation of mixed cryoglobulinaemia. Purpura improved in two patients after lowering homocysteine with vitamin supplementation.CONCLUSIONS:
Hyperhomocysteinaemia may be a risk factor for severe cutaneous manifestations in mixed cryoglobulinaemia.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Úlcera Cutânea
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Vasculite
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Hiper-Homocisteinemia
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Crioglobulinemia
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article