Marson P, Faggian D, Maran A, De Silvestro G
Servizio di Immunoematologia e Trasfusionale Modulo di Emocitoaferesi, Azienda Ospedaliera, Padova.
Minerva Med. 1998 Jul-Aug;89(7-8):277-81.
The hepatitis C virus (HCV) infection is characterized by a variety of extra-hepatic manifestations in many individuals. Among these, diabetes mellitus (DM) can be included, as such a metabolic disorder has been demonstrated to be more frequent in chronic hepatitis C than in liver disease due to other causes. Recently, we have observed that most patients affected with HCV-associated mixed cryoglobulinemia (13 out of 15, 86.7%), that were at baseline normoglycemic, developed DM following corticosteroid treatment (prednisone > 25 mg/daily) for at least three months. Conversely, when we consider a control group including 36 HCV negative patients affected with various immunomediated disorders, i.e., systemic lupus erythematosus, myasthenia gravis, poly/dermatomyositis and chronic inflammatory demyelinating polyneuropathy, that were initially normoglycemic, corticosteroid induced DM (prednisone > 25 mg/daily for at least three months) occurred only in 16.7% of subjects. Moreover, in other two HCV positive patients suffering from myasthenia gravis, prolonged corticosteroid treatment was complicated by DM. These data, that are still unclear from a pathophysiologic viewpoint, seem to indicate corticosteroid induced DM as a further, unusual extra-hepatic manifestation of the HCV infection.
丙型肝炎病毒（HCV）感染在许多个体中表现为多种肝外表现。其中包括糖尿病（DM），因为已证明这种代谢紊乱在慢性丙型肝炎中比在其他原因引起的肝病中更为常见。最近，我们观察到，大多数基线血糖正常的丙型肝炎病毒相关混合性冷球蛋白血症患者（15例中有13例，占86.7%）在接受皮质类固醇治疗（泼尼松>25毫克/天）至少三个月后发展为糖尿病。相反，当我们考虑一个包括36例丙型肝炎病毒阴性且患有各种免疫介导疾病（即系统性红斑狼疮、重症肌无力、多/皮肌炎和慢性炎症性脱髓鞘性多发性神经病）的患者的对照组时，这些患者最初血糖正常，皮质类固醇诱导的糖尿病（泼尼松>25毫克/天至少三个月）仅发生在16.7%的受试者中。此外，在另外两名患有重症肌无力的丙型肝炎病毒阳性患者中，长期皮质类固醇治疗并发了糖尿病。这些从病理生理学角度仍不清楚的数据似乎表明，皮质类固醇诱导的糖尿病是丙型肝炎病毒感染另一种不寻常的肝外表现。
