Hypertrophic cardiomyopathy secondary to hepatitis c virus-related vasculitis

Giulio Cavalli, Alvise Berti, Gabriele Fragasso, Francesco De Cobelli

Research output: Contribution to journalArticle

Abstract

Almost invariably associated with chronic HCV infection, cryoglobulinemic vasculitis is a small-vessel vasculitis commonly affecting the skin, kidneys, and peripheral nervous system. Cardiac involvement, possibly due to cardiac microcirculation involvement, is an utterly rare and severe complication. We describe a case of hypertrophic cardiomyopathy secondary to cryoglobulinemic vasculitis. Evaluation with transthoracic cardiac ultrasound and cardiac MRI evidenced severe left ventricular hypertrophy and diffuse hypokinesia, a marked decrease in left ventricular ejection fraction, and a subtle late enhancement of inferior and lateral left ventricular walls. Upon clinical stabilization, the patient received treatment with anti-CD20 monoclonal antibody rituximab. Clinical and radiological follow-up with cardiac ultrasound and cardiac MRI documented a dramatic and sustained clinical improvement, with marked reduction of left ventricular hypertrophy, resolution of late enhancement, recovery of left ventricular contractility and function.

Original languageEnglish
JournalJournal of Cardiovascular Medicine
DOIs
Publication statusAccepted/In press - Jun 28 2014

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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