title: Differentiation of rheumatoid arthritis from hepatitis C-related arthropathy: case report.
abstract: Chronic virus C hepatitis records high prevalence, almost 170 million people worldwide being infected. Systemic involvement is frequent and the implication of the osteoarticular system raises various problems in properly diagnosing and treating it. Rheumatoid arthritis is the most frequent type of inflammatory polyarthritis, with a prevalence of 0.8% in the general population. The rheumatoid factor recorded high values at virus C hepatitis patients (19-80%) even in the absence of articular manifestations, its sensitivity and specificity being reduced for the rheumatoid arthritis diagnosed simultaneous with virus C hepatitis. We report a case of chronic virus C hepatitis patient which, after 30 years of evolution, presents the onset of senile rheumatoid polyarthritis. The authors discuss the usefulness dosage of anti-cyclic citrullinated peptide antibodies for establishing the differential diagnosis between rheumatoid arthritis and hepatitis C-related arthropathy and the particularities of the specific treatment when there is a hepatitis C virus associated infection.
authors.forename: Corina
authors.initials: C
authors.lastname: Dima-Cozma
authors.forename: F
authors.initials: F
authors.lastname: Mitu
authors.forename: Luana
authors.initials: L
authors.lastname: Macovei
authors.forename: Oana
authors.initials: O
authors.lastname: Arhire
authors.forename: Elena
authors.initials: E
authors.lastname: Rezuş
mesh_terms: D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000276:immunology* / Q000821:virology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D007155:Immunologic Factors / Q000097:blood*; D010456:Peptides, Cyclic / Q000097:blood; D011237:Predictive Value of Tests; D012217:Rheumatoid Factor / Q000097:blood*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000888:Antibodies, Anti-Idiotypic; D018501:Antirheumatic Agents; D015415:Biomarkers; D007155:Immunologic Factors; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D006886:Hydroxychloroquine; D012217:Rheumatoid Factor