A case of hepatitis C virus-related mixed cryoglobulinemic vasculitis with chronic diarrhea

A woman in her 50s with a medical history of chronic hepatitis C virus (HCV) infection presented to our hospital with arthralgia, diarrhea, and fever. We performed colonoscopy and found scattered erosions at the terminal ileum. Furthermore, the biopsy specimen from the ileum and colon showed non-specific enterocolitis. Two weeks later, she was admitted to our hospital due to worsening neuropathy, proteinuria, and skin rash. On the next day, her abdominal pain worsened, and she had bloody stools. Repeat colonoscopy performed without bowel preparation revealed multiple erosions at the colon, and biopsy specimen from the colon exhibited narrowing of the lumen of the blood vessels. The presence of serum cryoglobulin and untreated chronic HCV infection is consistent with the diagnosis of hepatitis C virus-related mixed cryoglobulinemic vasculitis.