Unusual biopsy findings in a hepatitis C-infected white man with cryoglobulinemia, purpuric rash, and renal failure

D H 1 HE DIFFERENTIAL DIAGNOSIS of renal failure in intravenous (IV) drug abusers is arge. IV heroin abusers may develop a distincive form of focal segmental glomerulosclerosis nown as heroin-associated nephropathy. They lso are at increased risk for the development of epatitis C virus (HCV) infection and its renal omplications, including membranous and memranoproliferative glomerulonephritis with or ithout associated cryoglobulinemia. Other nfections, such as hepatitis B or human immunoeficiency virus, may lead to membranous or embranoproliferative glomerulopathy and huan immunodeficiency virus–associated nehropathy. Long-term IV drug users who resort o the practice of “skin popping” are predisposed o develop secondary amyloidosis-related kidney isease. We report an unusual presentation of enal disease in a white “skin popper” with hronic HCV infection.