Ultrasound detection of abdominal lymphadenomegaly in subjects with hepatitis C virus infection and persistently normal transaminases: a predictive index of liver histology severity

Soresi, Maurizio; Carroccio, Antonio; Bonfissuto, Giulio; Agate, Vincenzo; Magliarisi, C; Aragona, F; Levrero, Massimo; Notarbartoló, A; Montalto, Giuseppe

doi:10.1016/s0168-8278(98)80276-6

Cited by 34 publications

(21 citation statements)

References 24 publications

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“…Recent studies suggest that insulin resistance mediated by proinflammatory cytokines, rather than a deficit in insulin secretion, is the primary pathogenic mechanism involved in the development of type 2 diabetes in HCV infection [58] . Soresi et al [59] detected abdominal lymphadenopathy in 22% patients with HCV infection and persistently normal transaminases, and in 38% of those with high alanine aminotransferase values. Multiple logistic regression analysis showed a significant relationship between abdominal lymphadenopathy and histological abnormalities of the liver, presence of HCV RNA in the serum and gamma-globulin levels [59] .…”

Section: Discussionmentioning

confidence: 98%

“…Soresi et al [59] detected abdominal lymphadenopathy in 22% patients with HCV infection and persistently normal transaminases, and in 38% of those with high alanine aminotransferase values. Multiple logistic regression analysis showed a significant relationship between abdominal lymphadenopathy and histological abnormalities of the liver, presence of HCV RNA in the serum and gamma-globulin levels [59] . Lymphadenopathy in chronic HCV infection indicates a possible interaction between viral antigens and the immune system [60] .…”

Section: Discussionmentioning

confidence: 98%

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Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Stefanova-Petrova¹,

Tzvetanska²,

Naumova³

et al. 2007

WJG

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AIM: To a s s e s s t h e p r e va l e n c e o f e x t ra h e p a t i c manifestations in Bulgarian patients with chronic hepatitis C virus (HCV) infection and identify the clinical and biological manifestations associated with cryoglobulinemia. METHODS:The medical records of 136 chronically infected HCV patients were reviewed to assess the prevalence of extrahepatic manifestations. Association between cryoglobulin-positivity and other manifestations were identified using χ 2 and Fisher's exact test. Risk factors for the presence of extrahepatic manifestations were assessed by logistic regression analysis. RESULTS:Seventy six percent (104/136) of the patients had at least one extrahepatic manifestation. Clinical manifestations included fatigue (59.6%), kidney impairment (25.0%), type 2 diabetes (22.8%), paresthesia (19.9%), arthralgia (18.4%), palpable purpura (17.6%), lymphadenopathy (16.2%), pulmonary fibrosis (15.4%), thyroid dysfunction (14.7%), Raynaud's phenomenon (11.8%), B-cell lymphoma (8.8%), sicca syndrome (6.6%), and lichen planus (5.9%). The biological manifestations included cryoglobulin production (37.5%), thrombocytopenia (31.6%), and autoantibodies: anti-nuclear (18.4%), anti-smooth muscle (16.9%), anti-neutrophil cytoplasm (13.2%) and anti-cardiolipin (8.8%). All extrahepatic manifestations showed an association with cryoglobulin-positivity, with the exception of thyroid dysfunction, sicca syndrome, and lichen planus. Risks factors for the presence of extrahepatic manifestations (univariate analysis) were: age ≥ 60 years, female gender, virus transmission by blood transfusions, longstanding infection (≥ 20 years), and extensive liver fibrosis. The most significant risks factors (multivariate analysis) were longstanding infection and extensive liver fibrosis. CONCLUSION:We observed a high prevalence of extrahepatic manifestations in patients with chronic HCV infection. Most of these manifestations were associated with impaired lymphoproliferation and cryoglobulin production. Longstanding infection and extensive liver fibrosis were significant risk factors for the presence of extrahepatic manifestations in HCV patients.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Stefanova-Petrova¹,

Tzvetanska²,

Naumova³

et al. 2007

WJG

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“…Subjects with HCV infection and normal ALT values were followed up, and the results showed that those with increases in ALT levels had lymph nodes larger than those of subjects with persistently normal ALT levels. 25 Nodal sizes were also positively correlated with viremia 19,22 and could be markers for the virological response in the treatment of chronic hepatitis C. 29,32 However, they may be correlated with serological values that would consequently become controversial. 17,22,24,29 Our study demonstrated that different parameters of nodal size led to different results and that nodal width might be superior to other parameters in terms of representing a lymph node in its reactive state.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17][18][19][20][22][23][24] A few studies have included lymph nodes of healthy subjects and asymptomatic subjects with anti-HCV antibodies with normal transaminase values. 25,26 In these studies, nodal sizes and their clinical significance differed.…”

mentioning

confidence: 94%

Enlarged lymph nodes in porta hepatis: Sonographic sign of chronic hepatitis B and C infections

Kuo

Lin

Chen

et al. 2006

J of Clinical Ultrasound

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“…In clinical practice, it is increasingly frequent to find HCV-positive patients with persistently normal aminotransferase levels and variable degrees of liver histological damage [19][20][21][22]. The natural history as well as the best treatment for these patients is at present unknown.…”

Section: Introductionmentioning

confidence: 99%

Circulating Intercellular Adhesion Molecule-1 in Chronic Hepatitis C Patients with Normal or Elevated Aminotransferase before and after Alpha-Interferon Treatment

Montalto

Giannitrapani²,

Soresi³

et al. 2003

Intervirology

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Objectives: Intercellular adhesion molecule-1 (ICAM-1) plays a fundamental role during liver inflammation. In fact, weak ICAM-1 expression is physiologically restricted to the endothelium of portal vessels and to sinusoidal lining cells, but it becomes markedly evident on sinusoidal lining cells and at the surface of hepatocytes during inflammatory liver diseases. The aim of this study was to evaluate the behaviour of soluble ICAM-1 (sICAM-1) in chronic hepatitis C (CH-C) patients with persistently normal aminotransferase in comparison with patients with CH-C and elevated aminotransferase, and its changes during α-interferon (IFN) therapy. Immunohistochemical localization of ICAM-1 was also performed on liver tissue specimens of both groups. Methods: Sixty subjects were divided into 3 groups: group A included 19 patients with CH-C and persistently normal aminotransferase; group B included 21 patients with CH-C and persistently elevated aminotransferase levels, and group C included 20 healthy subjects representing the control group. The first two groups were treated with recombinant α-IFN 2b at a dose of 6 MU 3 times a week for 3 months and followed up with 3 MU 3 times a week for another 3 months. Results: Baseline values of serum ICAM-1 in groups A and B were significantly higher than those in group C (p < 0.0001). The median baseline value of sICAM-1 in group A (525.0 ng/ml) was lower than that of group B (561.0 ng/ml), but the difference was not statistically significant. Furthermore, there was a trend toward higher ICAM-1 values as histological severity increased (Mantel-Haenszel χ² 8.8, p < 0.003). Post-treatment sICAM-1 serum values showed a marked decrease in both groups, but only among responder patients, while ICAM-1 levels were unchanged in non-responders. Immunohistochemical localization showed no staining for ICAM-1 in normal liver specimens, while there was a quite similar staining for ICAM-1 in the two groups of patients, consistent with an inflammatory process. Conclusions: This study shows that circulating ICAM-1 levels in most patients with CH-C and persistently normal aminotransferase are higher than those in a control group and the fact that ICAM-1 molecules are also expressed on the hepatocyte membrane suggests that they could play an important role, in association with other molecules, in the intercellular adhesion processes during the induction and maintenance phases of the immune response. In both groups, only patients responding to α-IFN therapy showed a marked decrease in serum ICAM-1 below baseline values.

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Ultrasound detection of abdominal lymphadenomegaly in subjects with hepatitis C virus infection and persistently normal transaminases: a predictive index of liver histology severity

Cited by 34 publications

References 24 publications

Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Enlarged lymph nodes in porta hepatis: Sonographic sign of chronic hepatitis B and C infections

Circulating Intercellular Adhesion Molecule-1 in Chronic Hepatitis C Patients with Normal or Elevated Aminotransferase before and after Alpha-Interferon Treatment

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