Krioglobulinemia i jej związek z pozawątrobowymi objawami przewlekłego wirusowego zapalenia wątroby typu C
Journal Title: Advances in Hygiene and Experimental Medicine - Year 2017, Vol 71, Issue
Abstract
Cryoglobulinemia is a condition with a confirmed relationship with HCV infection, but many other extrahepatic symptoms are also present in hepatitis C. Cel: The aim of this study was to assess the incidence and type of extrahepatic manifestations and cryoglobulinemia as well as their correlation with clinical symptoms in Polish patients. Materiały i metody: 246 consecutive patients with hepatitis C were studied. Clinical symptoms were assessed by anamnesis and a clinical investigation. Cryoglobulins were estimated by a method basing on their ability to reverse precipitation in temperature +4ºC. Monoclonality of cryoglobulins was estimated by agarophoresis immunotyping – capillary electrophoresis and immunofixation. The presence of classical rheumatoid factor (RF-IgM) was tested using ELISA. Anti-nuclear antibodies (ANA) were tested using the indirect immunofluorescence method. Anti-CCP, anti-SSA, anti-α-fodrin antibodies, RF IgG, IgM and IgA were assessed using commercial enzymatic tests. Statistical methods were: Fisher exact test, generalized additive models, odds ratios with 95% confidence intervals, aid of spline curve, SAS system version 9.4. Wyniki: Cryoglobulins were found in 93 persons (37.8%). Type II cryoglobulinemia was detected in 28 persons. Patients with cryoglobulinemia were elder (p<0.0004). 54 patients (21.95%) manifested clinical extrahepatic symptoms. Arthralgia was found in 27 cases (10.98%). Skin changes were found in 22 patients (8.94%). 12 persons had glomerulonephritis (4.88%). 11 patients (4.47%) had sicca syndrome. 6 patients developed peripheral polyneuropathy (2.4%). 4 persons developed B cell lymphoma (1.63%). There was no correlation between presence of symptoms and grading, staging, age, HCV genotype, and the presence of autoantibodies. Extrahepatic manifestations were present more frequently in women (p<0.0008).
Authors and Affiliations
Joanna Jabłońska, Jakub Ząbek, Bożena Walewska-Zielecka, Zbigniew Lewandowski, Alicja Wiercińska-Drapało
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