Performance of the preliminary classification criteria for cryoglobulinaemic vasculitis and clinical manifestations in hepatitis C virus-unrelated cryoglobulinaemic vasculitis
L. Quartuccio, M. Isola, L. Corazza, M. Maset, G. Monti, A. Gabrielli, A.G. Tzioufas, C. Ferri, G. Ferraccioli, M. Ramos-Casals, M. Voulgarelis, M. Lenzi, M.T. Mascia, D. Sansonno, P. Cacoub, M. Tomsic, A. Tavoni, M. Pietrogrande, A.L. Zignego, S. Scarpato, P. Pioltelli, S. Steinfeld, P. Lamprecht, M. Galli, S. Bombardieri, S. De Vita
2012 Vol.30, N°1 ,Suppl.70
PI 0048, PF 0052
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PMID: 22410397 [PubMed]
Accepted : 24/01/2012
In Press: 14/05/2012
BACKGROUND: Cryoglobulinaemic vasculitis (CV) is often related to hepatitis C virus (HCV) infection, but it can develop in other diseases (e.g. other infections, connective tissue diseases, malignancies) in the absence of HCV infection. A comparison of the performance of the recently published classification criteria for the CV was made between HCV-positive and HCV negative patients with serum cryoglobulins.
500 patients with serum cryoglobulins were studied. Their mean age was 60.77±13.75 years, they were 356 females (71.2%) and 144 males (28.8%). CV was diagnosed in 272 patients (54.4%), while other diseases associated with serum cryoglobulins without CV (CwV) were diagnosed in 228 patients (45.6%).
117 HCV negative patients were collected (23.4%) and they were 42/272 (15.4%) among the CV group, while they were 75/228 (32.9%) among the CwV. In HCV negative patients the sensitivity and specificity of the classification criteria of CV were 89.5% CI 95% [79.5–99.5] and 90.3% CI 95% [82.8–97.8], respectively, while in HCV positive patients they were 88.3% CI 95% [83.6%–93.1%] and 96.1% CI 95% [91.8–100], respectively. The most frequent disease recognised among the HCV negative patients was Sjögren`s syndrome (SS) (55/117, 47.0%), and the sensitivity and the specificity of the CV classification criteria were 88.9% CI 95% [76.5–100] and 91.3% CI 95% [79.2–100], respectively.
The classification criteria for CV showed a good performance even in HCV-unrelated patients. A slightly lower specificity was observed for the classification of HCV-unrelated CV, since some clinical manifestations included in the clinical item for the classification criteria occurred more frequently in HCV-negative rathre than HCV-positive controls with CWV.