Thyroid involvement in HCV-related cryoglobulinemic vasculitis

Background: A striking association has been demonstrated between cryoglobulinemic vasculitis (CV) and hepatitis C virus (HCV) infection. CV is characterised by multiple organ involvement, secondary to immune-complex-mediated small vessel vasculitis.Objectives: The present study aimed to investigate the prevalence and characteristics of thyroid disorders (hypo- or hyperthyroidism, thyroid autoantibodies, thyroid nodules and cancer) in an unselected series of HCV-associated CV patients (HCV-CV).Methods: Ninety-nine HCV-CV (19 males and 80 females, mean age 64±9.8SD years, mean disease duration 14±7.5SD years) were studied and each one was randomly matched by sex and age (±2 years), with: 1) one subject of the general population from the same area; 2) one patient with type C chronic hepatitis (CH) without CV.Results: The prevalence of the following thyroid abnormalities was significantly higher in HCV-CV compared to the other groups: serum antithyroperoxidase autoantibody (AbTPO) (28% vs 8.7% and 14%, respectively; p<0.0022); presence of AbTPO and/or antithyroglobulin autoantibody (31% vs 12% and 19%, respectively, p<0.009); subclinical hypothyroidism (11% vs 2.3% and 7%, respectively; p<0.04). Thyroid papillary cancer was observed in 2 HCV-CV and in none of the controls.Conclusion: HCV-CV patients showed a significantly high prevalence of different thyroid disorders; thus, a careful thyroid surveillance is advisable in these individuals.