American Board of Internal Medicine (ABIM) Certification Practice Exam

Which type of hepatitis is associated with cryoglobulinemic glomerulonephritis?

1. Hepatitis A

2. Hepatitis B

3. Hepatitis C

4. Hepatitis D

The correct answer is: Hepatitis C

Cryoglobulinemic glomerulonephritis is primarily associated with Hepatitis C. This association arises because Hepatitis C virus (HCV) infection can lead to the formation of cryoglobulins, which are abnormal proteins in the blood that precipitate at lower temperatures. The presence of these proteins can cause inflammation and damage to the kidneys, specifically leading to cryoglobulinemic glomerulonephritis. This condition is characterized by a triad of symptoms: purpura, arthralgia, and renal involvement, which are linked to the underlying systemic effects of the infection with Hepatitis C. The mechanisms by which HCV induces cryoglobulinemia include the persistent viral infection leading to chronic inflammation and immune complex formation. Hepatitis B and D can also cause renal complications, but they are not typically associated with cryoglobulinemic glomerulonephritis in the same manner as Hepatitis C. Hepatitis A, on the other hand, is an acute viral infection that does not cause chronic liver disease or associated cryoglobulinemia.