skip to main content

Cryoglobulinaemic Vasculitis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardRheumatologyCryoglobulinaemic VasculitisRACP Adult Medicine

A 55-year-old woman with chronic hepatitis C presents with palpable purpura, arthralgia, and peripheral neuropathy. Serum complement (C4) is very low. Cryoglobulins are positive (type II: mixed monoclonal IgM with polyclonal IgG). Rheumatoid factor is positive. Kidney biopsy shows membranoproliferative glomerulonephritis. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Cryoglobulinaemic vasculitis

Palpable purpura, arthralgia, neuropathy, low C4, positive cryoglobulins (type II), positive RF, and MPGN in a patient with hepatitis C is cryoglobulinaemic vasculitis. Type II (mixed) cryoglobulinaemia is most commonly associated with HCV. Treatment addresses the underlying HCV (DAA therapy) plus rituximab for severe organ involvement.

Reference: ACR – 2021 – Vasculitis Guidelines; EASL HCV Guidelines 2024