Extrahepatic manifestations of chronic hepatitis C

Abstract

Chronic hepatitis C virus (HCV) infection is associated with several extrahepatic disorders. Although the exact pathogenesis of these conditions is not fully understood, several studies have provided insight into the role of HCV in their development. This review discusses the different conditions that have been associated with HCV infection. Among the most commonly reported are cryoglobulinemia, membranoproliferative glomerulonephritis, leukocytoclastic vasculitis, Sjogren's syndrome, lichen planus and porphyria cutanea tarda. In some patients, these disorders are the first sign of HCV infection.

Vitiligo Improvement in a Hepatitis C Patient After Treatment With PEG-Interferon α-2A and Ribavirin: A Case Report

“…It is a well known cause of chronic liver disease and hepatocellular carcinoma, but has also been associated with a wide variety of extrahepatic manifestations. The most documented conditions include autoimmune thrombocytopenic purpurae, glomerulonephritis, and thyroiditis [1,2]. More recently, hepatitis C has been linked with a number of dermatologic manifestations such as lichen planus, alopecia areata, porphyria cutanea tarda, essential mixed cryoglobulinemia, and pruritus [3].…”

Dermatologic Extrahepatic Manifestations of Hepatitis C

“…5 ). 27 Other manifestations include increased skin fragility, hypertrichosis (especially involving lateral aspect of the face), chronic hyper/hypopigmentation, chloracne, sclerodermoid changes, dystrophic calcifications with ulcerations, scarring, alopecia, and onycholysis. Patients can also manifest stigmata of advanced liver disease and cirrhosis if the latter is present.…”

Extrahepatic Manifestations of Hepatitis C Virus: An Extending List

“…Commonly involved (95% of cases) with a cutaneous vasculitis ranging from palpable purpura (leukocytoklastic vasculitis) and petechiae in the lower extremities to large necrotic ulcerations. Raynaud's phenomenon occurs in up to 1/3 of cases and involves hands, feet, lips, ears, and the tip of the nose [20] Figure (1): Leukocytoclastic vasculitis [21]…”

“…It commonly presented as rheumatoid like symmetrical inflammatory polyarthritis involving mainly small joints or less commonly as mono or oligoarthritis of large joints [21]. In about 2/3 of the affected individuals, morning stiffness may be severe, resolving after more than an hour [120].…”

“…Differentiation may be difficult. HCV related arthritis usually runs a relatively benign course that is typically non deforming [21]. Furthermore, unlike classic RA, ESR is elevated only in about half of the patients, articular bony erosions and subcutaneous nodules are absent [120].…”