Figure 8

Treatment of mixed cryoglobulinemia (MC) syndrome according to the etiopathogenesis of the disease (1). MC is the result of a multistep process including three main clinico-pathological levels: 1) chronic HCV infection, 2) B-lymphocyte proliferation, and 3) immune-complex-mediated vasculitis (cryoglobulinemic vasculitis). Following the cascade of events leading from HCV infection to overt vasculitic syndrome, we can treat the patients at different levels by means of etiologic, pathogenetic, and/or symptomatic therapies (see also Fig. 6, 9, and 10). RF: rheumatoid factor; CIC: circulating immune-complexes; LAC-diet: low-antigen-content diet. (modified from [25]: Ferri C and Mascia MT, Curr Opin Rheumatol 2006, 18: 54–63, with permission from Lippincott Williams & Wilkins).