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Cryoglobulinaemic Vasculitis — RACP Adult Medicine MCQ

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HardRheumatologyCryoglobulinaemic VasculitisRACP Adult Medicine

A 55-year-old man with chronic hepatitis C presents with a palpable purpuric rash and arthralgia. Complement C4 is very low. Which autoantibody/investigation is most likely positive?

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Correct answer: D — Rheumatoid factor and cryoglobulins

Hepatitis C-associated cryoglobulinaemic vasculitis characteristically has positive rheumatoid factor (RF) and cryoglobulins (type II mixed) with very low C4 (consumed by immune complex formation). ANA may also be positive but is non-specific. The combination of RF + cryoglobulins + low C4 in HCV is the key diagnostic pattern.

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