Type 1 Immunoglobulin M Cryoglobulinemic Vasculitis in a Patient with Chronic Lymphocytic Leukemia and a History of Hepatitis C Virus: Is There a Link?

Hepatitis C virus (HCV) is considered a hepatotropic and, increasingly, a lymphotropic virus. Research suggests an association between HCV infection and the subsequent development of non-Hodgkin lymphomas (NHL). HCV is also a well-known etiologic factor in the development of type II cryoglobulinemic vasculitis while type I cryoglobulinemic vasculitis results from monoclonal immunoglobulin secondary to malignancy. Is there a link among HCV, NHL, and type I cryoglobulinemia? This question is posed in a case of aggressive type 1 cryoglobulinemic vasculitis in a patient with chronic lymphocytic leukemia and a history of HCV. I theorize on an intriguing pathogenesis of how HCV may have led to B cell malignancy and the subsequent development of type I cryoglobulinemic vasculitis in this patient.