Non-invasive B-cell clonality markers may help in the rational approach to HCV SVR cryoglobulinemic patients with persisting manifestations

Background: Mixed cryoglobulinemia (MC), a both autoimmune and lymphoproliferative disorder (LPD), is characterized by the clonal expansion of B-cell populations, mostly in the liver and, less frequently, in the bone marrow or blood. DAAs can improve or heal MC vasculitis, but persistence or recurrence may be observed after SVR. Rituximab (RTX) is the first-choice therapy in such cases. However, MC persistence may also be due to other causes, including the occurrence of irreversible organ/tissue damage.

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