Atypical arthritis due to combined hereditary hemochromatosis and active hepatitis C.
A 51-year-old Caucasian female presented with asymmetric arthritis and a positive rheumatoid factor. She was initially treated for rheumatoid arthritis. However, she had features such as abnormal liver function tests and osteoarthritis in an unusual location, the metacarpophalangeal joint. Further workup revealed that the patient had active hepatitis C and hereditary hemochromatosis. Phlebotomy treatment initiation seemed to be associated with improvement in joint symptoms but, more importantly, may have prevented future risk of cirrhosis and hepatocellular cancer. Treatment for the hepatitis C may also be needed. Clinicians should look for underlying systemic illnesses leading to atypical inflammatory arthritis.
Zafar
Sara
S
From the Dubai Bone and Joint Center, Emirates Towers, Dubai, UAE.
Badsha
Humeira
H
D001168:Arthritis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology; D005260:Female; D006432:Hemochromatosis / Q000150:complications* / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007501:Iron / Q000097:blood; D008875:Middle Aged; D018962:Phlebotomy; D011859:Radiography
D007501:Iron