Nocente Roberto, Ceccanti Mauro, Bertazzoni Giuliano, Cammarota Giovanni, Silveri Nicolò Gentiloni, Gasbarrini Giovanni
Emergency Department, Rome University, La Sapienza, Italy.
Hepatogastroenterology. 2003 Jul-Aug;50(52):1149-54.
Hepatitis C virus infection is associated with various extrahepatic manifestations such as mixed cryoglobulinemia, membranoproliferative glomerulonephritis and porphyria cutanea tarda. The link between mixed cryoglobulinemia and hepatitis C virus infection is actually well known. Interferon alpha therapy decreases hepatitis C viremia and improves the clinical signs and biochemical abnormalities of cryoglobulinemia. The rare combination of hepatitis C and panarteritis nodosa has still not been confirmed. The sicca syndrome also seems to be associated with hepatitis C virus, but this is not the typical Sjogren's syndrome. It is not yet well established if hepatitis C virus plays a pathogenic role in the development of thyroid dysfunction and autoimmune thyroiditis. Probably interferon therapy may be implicated in the development in this and other extrahepatic manifestations of hepatitis C virus infection. Although an epidemiological association of hepatitis C with lichen planus, neuropathies and other diseases has been observed, the etiological role and the pathogenic involvement of the hepatitis C infection remains unclear. Extrahepatic clinical manifestations are frequently observed in hepatitis C virus patients and involve primarily the joints, muscles, and skin. The most frequent immunological abnormalities include mixed cryoglobulins, antinuclear antibodies, and anti-smooth muscle antibodies.
丙型肝炎病毒感染与多种肝外表现相关,如混合性冷球蛋白血症、膜增生性肾小球肾炎和迟发性皮肤卟啉病。混合性冷球蛋白血症与丙型肝炎病毒感染之间的联系实际上是众所周知的。α干扰素治疗可降低丙型肝炎病毒血症,并改善冷球蛋白血症的临床症状和生化异常。丙型肝炎与结节性多动脉炎的罕见组合仍未得到证实。干燥综合征似乎也与丙型肝炎病毒有关,但这并非典型的干燥综合征。丙型肝炎病毒在甲状腺功能障碍和自身免疫性甲状腺炎的发生发展中是否起致病作用尚未明确。可能干扰素治疗与丙型肝炎病毒感染的这种及其他肝外表现的发生有关。尽管已观察到丙型肝炎与扁平苔藓、神经病变及其他疾病之间存在流行病学关联,但丙型肝炎感染的病因学作用和致病机制仍不清楚。肝外临床表现常见于丙型肝炎病毒感染患者,主要累及关节、肌肉和皮肤。最常见的免疫异常包括混合性冷球蛋白、抗核抗体和抗平滑肌抗体。