Ignatova T M, Aprosina Z G, Serov V V, Mukhin N A, Krel' P E, Semenkova E N, Popova I V, Tanashchuk E L
Ter Arkh. 1998;70(11):9-16.
To study incidence, special features and mechanisms underlying onset of extrahepatic lesions in HCV-infection.
Extrahepatic symptoms of chronic hepatitis C and its outcome--hepatic cirrhosis were studied in 157 patients. HCV-infection was confirmed by ELISA II and polymerase chain reaction (detection in the serum of anti-HCV and HCVRNA, respectively). Morphological studies of the liver were made in 134 patients, of other organs and tissues--in 20 patients. Immunological tests were made in 124 patients. Thyroid hormones, antibodies to thyroglobuline were measured with radioimmunoassay in 74 patients.
Extrahepatic manifestations were found in 70(44.6%) patients with chronic hepatitis C (more frequently in hepatic cirrhosis), for the most part in women and in long-lasting disease. 54(43.5%) women had cryoglobulinemia, 27 of them showed it clinically. Patients with cryoglobulinemia and free of it exhibited varying frequency cutaneous vasculitis, Raynaud's syndrome, affection of the muscles and joints, nodular periartheritis, lesions of the lungs, myocarditis, autoimmune thyroiditis, Sjogren's syndrome, lichen ruber planus, porphyria cutanea tarda, immune cytopenia, autoimmune hemolytic anemia, hypoplastic anemia, monoclonal immunoglobulinopathy, B-cell lymphoma. Of high frequency were activity of rheumatic factor (66.9%), hypocomplementemia (31.8%), antinuclear antibodies (9.8%) and other immunological disorders.
Some extrahepatic lesions in HCV-infection are detailed: frequent mixed cryoglobulinemia and associated vasculitides of different sites, malignant lymphoproliferative diseases, more frequent than in HBV-infection involvement of the thyroid and salivary glands, some skin lesions.
研究丙型肝炎病毒（HCV）感染时肝外病变的发生率、特点及发病机制。
对157例慢性丙型肝炎及其转归——肝硬化患者的肝外症状进行研究。采用酶联免疫吸附试验II（ELISA II）和聚合酶链反应（分别检测血清中的抗HCV和HCVRNA）确诊HCV感染。对134例患者的肝脏进行形态学研究，对20例患者的其他器官和组织进行形态学研究。对124例患者进行免疫学检测。采用放射免疫分析法对74例患者检测甲状腺激素、甲状腺球蛋白抗体。
70例（44.6%）慢性丙型肝炎患者出现肝外表现（肝硬化患者中更为常见），大部分为女性且病程较长。54例（43.5%）女性有冷球蛋白血症，其中27例有临床症状。有冷球蛋白血症和无冷球蛋白血症的患者出现不同频率的皮肤血管炎、雷诺综合征、肌肉和关节病变、结节性动脉周围炎、肺部病变、心肌炎、自身免疫性甲状腺炎、干燥综合征、扁平苔藓、迟发性皮肤卟啉病、免疫性血细胞减少、自身免疫性溶血性贫血、再生障碍性贫血、单克隆免疫球蛋白病、B细胞淋巴瘤。风湿因子活性（66.9%）、补体低下（31.8%）、抗核抗体（9.8%）及其他免疫紊乱发生率较高。
详细阐述了HCV感染时的一些肝外病变：常见混合性冷球蛋白血症及相关的不同部位血管炎、恶性淋巴增殖性疾病、甲状腺和唾液腺受累较乙型肝炎病毒（HBV）感染更为常见、一些皮肤病变。
