Hepatitis C virus infection associated arthritis.
Hepatitis C-related arthropathy is one of the most common extra hepatic manifestations (EHMs) of HCV that may resemble rheumatoid arthritis (RA). Although symptoms can be disabling, prognosis typically is benign. The frequency and pattern of arthritis associated with chronic HCV patients and differentiation from RA was clinically, radiologically and laboratory studied. The study was carried out on two groups: GI: 100 patients diagnosed as RA according to the American College of Rheumatologist (ACR) and GII 100 chronic HCV patients. All patients underwent detailed history and complete general and locomotors examination. Complete blood picture (CBC), erythrocyte sedimentation rate (ESR), C reactive protein (CRP) and liver functions tests. HCV-RNA was done by HCV-RNA/RT-PCR. Anti-cyclic citrullinated peptide (Anti-CCP) antibody and rheumatoid factor (RF-IgM) was estimated by ELISA. Cryoglobulin were done to all patients. Plain X-rays for hands, wrists or knee were obtained on chronic HCV patients who had articular involvement at the time of anti-CCP antibody analysis. 17% GII had articular manifestations as 76.5% of them were polyarticular, while the remaining was monoarticular that associated with cryoglobulinemia. RF-IgM was 79% & 64.7% GI and HCV patients with articular manifestation (GII-A) respectively with no statistical significance. Anti-CCP was75 % and 11.7% positive of GI and GII-A respectively which was statistically significant. Cryoglobulinemia was positive in 15 % and 23.5% G1 and GII-A with no statistical significance.
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Nasr City, Cairo, Egypt.
Magdy A
MA
Al-Dahshan
Tarek A
TA
Al-Dahshan
D000328:Adult; D001168:Arthritis / Q000209:etiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged