Abstract: This  case  reports  a  47⁃year⁃old  male  patient  who  was  diagnosed  with  cryoglobulinemia  and  received treatments  including  antiviral  therapy  for  hepatitis  B  virus  （ HBV ），  glucocorticoids，  cyclophosphamide，  and  plasma exchange. However， his condition relapsed. Subsequently， he was treated with the RVD regimen targeting abnormal B cells and plasma cells in the bone marrow， but resulted in increased proteinuria and progression of renal function. After repeated renal  and  bone  marrow  biopsies  and  exclusion  of  heavy  metal  poisoning，  he  was  diagnosed  with  HBV⁃associated cryoglobulinemia. Following retreatment with glucocorticoids combined with cyclophosphamide， his symptoms improved with stabilized renal  function，  absence  of  gross  hematuria，  and  improved  complement  levels，  but  cryoglobulinemia  remained positive.

Key words: cryoglobulinemia ,  , hepatitis B virus ,  , glucocorticoids ,  , cyclophosphamide