RT Journal Article SR Electronic T1 Case of cryoglobulinaemia associated with chronic hepatitis B JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e249630 DO 10.1136/bcr-2022-249630 VO 15 IS 5 A1 Kolli, Himabindu A1 Ali, Mukarram Jamat A1 Campoverde Reyes, Karen J A1 Lau, Daryl T-Y YR 2022 UL http://casereports.bmj.com/content/15/5/e249630.abstract AB We present a case of a woman in her 50s with chronic hepatitis B (CHB) who had a longstanding history of arthralgia and swollen joints associated with severe fatigue. Investigations were consistent with a diagnosis of hepatitis B virus (HBV)-related cryoglobulinaemia. Two months after treatment with tenofovir alafenamide, an antiviral therapy for HBV, there was a significant improvement of her symptoms and undetectable serum cryoglobulins. Cryoglobulinaemia is a relatively rare extrahepatic manifestation of HBV infection and only presents in about 2%–4% of the patients with CHB. Its clinical manifestations include purpura, renal dysfunction, arthralgias and neuropathy. Since the presentation of cryoglobulinaemia in CHB can be non-specific, one needs to have a high index of suspicion to avoid delay in diagnosis and treatment.