{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:05:01Z","timestamp":1761609901295,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Essential mixed cryoglobulinaemia or type II cryoglobulinaemia is an important extrahepatic manifestation of chronic hepatitis C. Cryoglobulinaemia results in the deposition of immune complexes in small or medium-sized blood vessels leading to palpable purpura, arthralgia, renal disease and peripheral neuropathy. Posterior reversible encephalopathy syndrome (PRES) is a distinct phenomenon characterised by vasogenic oedema in the posterior circulation of brain. Cryoglobulinaemic vasculitis leading to spontaneous intracranial haemorrhage and PRES syndrome is rarely reported in the medical literature. In this report, we present an unusual case of spontaneous intracranial haemorrhage and PRES secondary to hepatitis C-associated cryoglobulinaemia presenting as right dense hemiplegia. Prompt institution of plasmapheresis resulted in successful resolution of symptoms in our patient, followed by full neurological recovery. To the best of our knowledge, this case describes the first successful use of plasmapheresis in alleviating neurological complications resulting from cryoglobulinaemic vasculitis and PRES secondary to chronic hepatitis C.<\/jats:p>","DOI":"10.1136\/bcr-2013-202717","type":"journal-article","created":{"date-parts":[[2014,1,20]],"date-time":"2014-01-20T10:58:22Z","timestamp":1390215502000},"page":"bcr2013202717","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Resolution of neurological deficits secondary to spontaneous intracranial haemorrhage and posterior reversible encephalopathy syndrome (PRES) in a patient with hepatitis C-associated cryoglobulinaemia: a role for plasmapheresis"],"prefix":"10.1136","volume":"2014","author":[{"given":"Delshad","family":"Ahmad","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Michigan State University, Flint, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haseeb","family":"Ilias Basha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Michigan State University, Flint, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basim","family":"Towfiq","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Michigan State University, Flint, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghassan","family":"Bachuwa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Michigan State University, Flint, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,1,20]]},"reference":[{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2893.2000.00204.x"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90132-5"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.3","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1016\/0016-5085(94)90022-1","article-title":"Cryoglobulinemia in chronic liver diseases: role of hepatitis C virus and liver damage","volume":"106","author":"Lunel","year":"1994","journal-title":"Gastroenterology"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.4","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/BOR.0b013e3282f1330c","article-title":"Treatment of hepatitis C-associated mixed cryoglobulinemia vasculitis","volume":"20","author":"Saadoun","year":"2008","journal-title":"Curr Opin Rheumatol"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.5","doi-asserted-by":"publisher","DOI":"10.1136\/ard.60.3.290"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.6","doi-asserted-by":"crossref","first-page":"6623","DOI":"10.1186\/1752-1947-3-6623","article-title":"Near fatal posterior reversible encephalopathy syndrome complicating chronic liver failure and treated by induced hypothermia and dialysis: a case report","volume":"26","author":"Chawla","year":"2009","journal-title":"J Med Case Rep"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.7","first-page":"1116","article-title":"C-type hepatitis in spontaneous intracerebral hemorrhage","volume":"48","author":"Aiba","year":"1996","journal-title":"No To Shinkei"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.8","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1588"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.9","doi-asserted-by":"publisher","DOI":"10.1177\/1076029607303531"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.10","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1681\/ASN.V73367","article-title":"Therapeutic plasma exchange in renal diseases","volume":"7","author":"Madore","year":"1996","journal-title":"J Am Soc Nephrol"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.11","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-0968.2003.00036.x"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.12","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510240405"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.13","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/14.2.281"},{"key":"2025082805352569000_2014.jan20_1.bcr2013202717.14","doi-asserted-by":"publisher","DOI":"10.1002\/art.20958"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-202717","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:35:33Z","timestamp":1756384533000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-202717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1,20]]},"references-count":14,"alternative-id":["10.1136\/bcr-2013-202717"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-202717","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2014,1,20]]}}}