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P Marson

Publications and source records attributed to P Marson.

41 records · Page 3Linked to original sources

[Extrahepatic manifestations of HCV infection].

It is well known that hepatitis C virus (HCV) can replicate outside the liver, particularly in the blood mononuclear cells. This fact may account for the systemic involvement, primarily due to immune-mediated mechanisms, which is commonly observed in patients affected with chronic hepatitis C. In this review the main extra-hepatic manifestations of the HCV infection are described and classified, according to the clinical involvement, namely dermatological, haematological, rheumatological, endocrinological, ophthalmological ad respiratory syndromes. In particular, the well-established causative role of HCV in determining certain clinical disorders, i.e., mixed cryoglobulinaemia and porphyria cutanea tarda, where the anti-HCV seroprevalence is higher than 70%, is emphasized. Moreover, some problems relevant to the diagnosis of the HCV infection in a proportion of autoimmune diseases (for example, primary Sjogren's syndrome), are discussed. Indeed, in these clinical disorders, hypergammaglobulinaemia, which represents an interfering factor with the results obtained by the screening anti-HCV tests, is a typical serologic feature.

Autoimmune Diseases↗

HLA expression in type II mixed cryoglobulinemia and chronic hepatitis C virus.

OBJECTIVE: Hepatitis C virus infection is closely associated not only with hepatic damage, but also with mixed cryoglobulinemia (MC) and other autoimmune and lymphoproliferative disorders. Because HCV is both hepatotropic and lymphotropic, the aim of this study was to investigate whether the genetic background may influence the clinical pattern seen in different patients. METHOD: Two groups of patients with HCV infection were studied: 16 with type II MC and 18 with chronic active hepatitis (CAH). 120 bone marrow donors were considered as the control group. In all patients HLA-A-B-C antigens were evaluated using the microlymphocytoxicity technique, and HLA-DR by the PCR-SSP method. RESULTS: The frequency of the HLA antigens expressed was not precisely defined in the two groups. However, the HLA-B51 and B35 antigens, which are often correlated with autoimmune disorders, were highly expressed in the MC patients (31.2%) compared to the controls (6.9%) and to the CAH group (11%). Moreover, HLA-A9 with its split A24 were present in 50% of the MC patients. More interesting was the expression of the HLA-DR7 antigen, which was found only in the CAH group, suggesting that it may influence the specific liver involvement in HCV infections. CONCLUSION: These findings indicate that the HLA system may play an important role in the clinical manifestations of HCV infection.

Adult↗

[Frequent occurrence of diabetes mellitus after corticosteroid treatment in mixed cryoglobulinemia. An HCV-related complication?].

The hepatitis C virus (HCV) infection is characterized by a variety of extra-hepatic manifestations in many individuals. Among these, diabetes mellitus (DM) can be included, as such a metabolic disorder has been demonstrated to be more frequent in chronic hepatitis C than in liver disease due to other causes. Recently, we have observed that most patients affected with HCV-associated mixed cryoglobulinemia (13 out of 15, 86.7%), that were at baseline normoglycemic, developed DM following corticosteroid treatment (prednisone > 25 mg/daily) for at least three months. Conversely, when we consider a control group including 36 HCV negative patients affected with various immunomediated disorders, i.e., systemic lupus erythematosus, myasthenia gravis, poly/dermatomyositis and chronic inflammatory demyelinating polyneuropathy, that were initially normoglycemic, corticosteroid induced DM (prednisone > 25 mg/daily for at least three months) occurred only in 16.7% of subjects. Moreover, in other two HCV positive patients suffering from myasthenia gravis, prolonged corticosteroid treatment was complicated by DM. These data, that are still unclear from a pathophysiologic viewpoint, seem to indicate corticosteroid induced DM as a further, unusual extra-hepatic manifestation of the HCV infection.

Adult↗