Electron microscopic and immunochemical studies in a patient with hepatitis C virus infection and mixed cryoglobulinemia type II.
Electron microscopic and immunochemical studies in a patient with hepatitis C virus infection and mixed cryoglobulinemia type II.
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丙型肝炎病毒感染和 II 型混合冷球蛋白血症患者的电子显微镜和免疫化学研究。
DOI：
10.1093/ajcp/102.3.278
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发表时间：
1994
影响因子：
3.5
通讯作者：
Underwood,JM
中科院分区：
文献类型：
--
作者：
Szymanski,IO;Pullman,JM;Underwood,JM
作者描述了一名丙型肝炎病毒（HCV）感染和II型混合性冷球蛋白血症患者，该患者多器官衰竭与所研究器官中典型的电子显微镜下可见的旁结晶小管沉积有关。患者的血浆冷沉淀物由单克隆IgM类风湿因子、多克隆IgG、HCV RNA和补体成分C3组成。在多克隆IgG中，几乎一半是抗HCV。IgG和IgM之间的摩尔比约为1.5比1。在外周血涂片上，冷沉淀物形成云状结构，这可能是诊断混合型冷球蛋白血症II的有用线索。血浆冷沉淀物和皮肤、肾小球毛细血管和血单核细胞沉积物的超微结构相同。肾小管的横截面直径为30.7 ± 1.6 nm（平均值± 1 SD），它们似乎被8个电子透明点包围。沉积在器官中的复合物含有HCV抗原和抗体，类风湿因子，和C3的多器官疾病在这个病人。
The authors describe patient with hepatitis C virus (HCV) infection and mixed cryoglobulinemia type II in whom multiorgan failure was associated with deposits of typical, electron-microscopically visualized paracrystalline tubules in the organs studied. The patient’s plasma cryoprecipitate was comprised of monoclonal IgM rheumatoid factor, polyclonal IgG, HCV RNA, and complement component C3. Of the polyclonal IgG, almost half was anti-HCV. The molar ratio between IgG and IgM was approximately 1.5 to 1. On peripheral blood films the cryoprecipitate formed cloudlike structures, which may be a useful diagnostic clue in mixed cryoglobulinemia type II. The ultrastructure of plasma cryoprecipitate and of deposits in skin, renal glomerular capillaries, and blood monocytes was identical. The cross-sectional diameter of the tubules was 30.7 ± 1.6 nm (mean ± 1 SD), and they appeared to be surrounded by eight electron-lucent dots. Deposition in organs of complexes containing HCV antigens and antibodies, rheumatoid factor, and C3 contributed to the multiorgan disease in this patient.