Ultrasound-detected abdominal lymphadenopathy in chronic hepatitis C: high frequency and relationship with viremia.
OBJECTIVE
This study aimed to investigate the prevalence and significance of ultrasound-detected deep abdominal lymphadenopathy in chronic hepatitis due to C virus.


METHODS
One hundred and thirty-four consecutive patients with various liver disorders were examined with portable real-time equipment.


RESULTS
In 25 (19%), the procedure failed because of excessive meteorism. Deep nodes, mainly located in the hepato-duodenal ligament, were detected in 62 of the remaining 109 patients (57%), reaching the highest prevalences in primary biliary cirrhosis (5/7, 71%), chronic hepatitis C (44/66, 67%) and autoimmune hepatitis type 1 (2/3, 67%). For all patients, including those with liver diseases with multiple etiology, lymphadenopathy was more frequent in anti-HCV positive (51/81, 63%) than in negative cases (11/28, 39% p=0.02). In chronic hepatitis C, serum HCV RNA was detected by nested polymerase chain reaction in all 31 patients with, but in only 75% (12/16) of those without nodes (p=0.018). No other distinct clinical or laboratory feature was found in association with lymphadenopathy; in particular, its incidence was similar in cases with and without liver cirrhosis.


CONCLUSIONS
Enlarged deep abdominal lymph nodes are frequently detected by ultrasound in patients with chronic hepatitis C. This feature may be of diagnostic utility, especially in early cases, when liver cirrhosis has not yet developed and therefore no other ultrasound sign of the underlying disease can be detected. Lymphadenopathy may be of biological significance, marking hepatitis C virus infection in a replicative, viremic stage. These observations support the existence of a close interaction between hepatitis C virus and the lymphatic system.
Cassani
F
F
Cattedra di Medicina Interna 1, Istituto di Clinica Medica Generale e Terapia Medica, University of Bologna, Italy.
Valentini
P
P
Cataleta
M
M
Manotti
P
P
Francesconi
R
R
Giostra
F
F
Ballardini
G
G
Lenzi
M
M
Zauli
D
D
Bianchi
F B
FB
D000005:Abdomen; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000276:immunology; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000276:immunology; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014766:Viremia / Q000150:complications* / Q000175:diagnosis / Q000276:immunology
D001323:Autoantibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral; C060729:anti-liver kidney microsome antibody