Extrahepatic manifestations of chronic viral hepatitis: possible associated complications must not be forgotten in daily clinical practice

Year 2012, Volume: 11 Issue: 3, - , 01.12.2012

Fatih Ermiş Ahmet Uyanıkoğlu Filiz Akyüz - Kadir Demir - Sabahattin Kaymakoğlu -

Abstract

Background and Aims:Hepatitis viruses induce not only chronic liver diseases but also the impairment of other organs and tissues as extrahepatic manifestations. It is necessary to consider possible complications associated with extrahepatic diseases in the treatment.Materials and Methods: We retrospectively evaluated the demographic features of 52 (2%) patients who had clinically symptomatic extrahepatic manifestations from among 2870 chronic viral hepatitis patients in the Gastroenterology Department of the Istanbul Medical Faculty between 1997 and 2010. Results: Twenty-seven of the 52 patients (52%) had hepatitis C, 24 (46%) hepatitis B, and 1 (2%) both hepatitis B and C. Of these, 25 (48%) were males, and the mean age was 51±13 (range, 18 to 78) years. Thirty-two patients (61%) were cirrhotic, while 20 (39%) were in the precirrhotic stage.Conclusions: Extrahepatic involvement is generally overlooked, and clinicians should be more sensitive to the diagnoses of these manifestations.

Keywords

Chronic hepatitis, extrahepatic manifestations

Kronik viral hepatitlerde ekstrahepatik bulgular: Günlük klinik pratikte unutulmaması gereken bir nokta

Abstract

Giriş ve Amaç:Hepatit etkeni virüsler kronik karaciğer hastalıklarına yol açmanın yanısıra ekstrahepatik bulgular olarak adlandırılan diğer organ ve dokularda da bozukluklara neden olabilirler. Tedavide ekstrahepatik tutulumları da gözardı etmemek gereklidir. Gereç ve Yöntem: İstanbul Tıp Fakültesi Gastroenteroloji Bilim Dalı'nda 1997-2010 yılları arasında takipli toplam 2870 hastada klinik olarak semptomatik ekstrahepatik tutulumu olan 52 hastanın (%2) demografik özellikleri retrospektif olarak değerlendirildi. Bulgular: Elli iki hastadan 27'si (%52) hepatit C, 24'ü (%46) hepatit B ve 1 (%2) hasta da hem hepatit B hem de hepatit C idi. Bunlardan 25'i (%48) erkekti, ortalama yafl 51±13 (18-78) yıldı. Otuz iki hasta (%61) sirotik evrede, 20 hasta (%39) ise presirotik evrede idi. Sonuç:Ekstrahepatik tutulumlar genellikle atlanmaktadır. Klinisyenler ekstrahepatik bulguların tanısında daha duyarlı olmalıdırlar.

Keywords

Kronik hepatit, ekstrahepatik bulgular

References

• Trepo C, Guillevin L. Polyarteritis nodosa and extrahepatic manifestations of HBV infection: the case against autoimmune intervention in pathogenesis. J Autoimmun 2001;16:269-74.
• Pascual M, Perrin L, Giostra E, et al. Hepatitis C virus in patients with cryoglobulinemia type II [letter]. J Infect Dis 1990;162:569-70.
• Ali A, Zein NN. Hepatitis C infection: a systemic disease with extrahepatic manifestations. Cleve Clin J Med 2005;72:1005-19.
• Kayali Z, Buckwold VE, Zimmerman B, et al. Hepatitis C, cryoglobulinemia, and cirrhosis: a meta-analysis. Hepatology 2002;36:978-85.
• Cacoub P, Poynard T, Ghillani P, et al. Extrahepatic manifestations of chronic hepatitis C. MULTIVIRC Group. Multidepartment Virus C. Arthritis Rheum 1999;42:2204-12.
• Agnello V, De Rosa FG. Extrahepatic disease manifestations of HCV infection: some current issues. J Hepatol 2004;40:341-52.
• Cacoub P, Saadoun D, Bourlière M, et al. Hepatitis B virus genotypes and extrahepatic manifestations. J Hepatol 2005;43:764-70.