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Cryoglobulinaemic vasculitis — SCE Rheumatology MCQ

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ModerateVasculitisCryoglobulinaemic vasculitisSCE Rheumatology

A 60-year-old woman with hepatitis C has palpable purpura, arthralgia, peripheral neuropathy and proteinuria. C4 is very low, rheumatoid factor is positive and cryoglobulins are detected. What is the most likely diagnosis?

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Correct answer: D — Mixed cryoglobulinaemic vasculitis

Hepatitis C, purpura, neuropathy, renal involvement, low C4 and positive cryoglobulins point to mixed cryoglobulinaemic vasculitis. IgA vasculitis can affect skin and kidneys but is not linked to low C4 and hepatitis C in this way. Management requires assessment of organ threat and antiviral therapy where appropriate.

Reference: EULAR vasculitis recommendations; BSR rheumatology curriculum