Revista Cubana de Medicina
versão On-line ISSN 1561-302X
CABALLERO MAYTIN, Juan Carlos; MERINO IBARRA, Erardo; RAMOS MARIN, Pedro e NASIFF HADAD, Alfredo. Hepatitis crónica C con manifestaciones extrahepáticas: Presentación de 1 caso. Rev cubana med [online]. 1997, vol.36, n.2, pp. 134-137. ISSN 1561-302X.
The case of a 43-year old patient presenting with a clinical picture of polyarthralgia, facial edema and edema of the legs progessing during the day and positive rheumatoid factor, is reported. Five months later, an hepatomegaly was detected and 2 weeks after the patient presented with non-opressive thoracic pain at rest acompanied by dysnea as a result of a pleuropericarditis with effusion and evidenced by radiology. Five days after the patient had fever up to 39 C with chills, nausea, vomiting, abdominal colics and liquid diarrhea repeated several times a day. All those symptoms disapeared spontaneously 2 weeks later. Afterwards digital hypocratism of the feet an skin vasculitis in non-acute phase in the lower third of the legs were observed. Complementary examinations revealed mild anemia, VSG 65 mm/h, creatinine 198 micromol/L, ASAT 57 U/L, ALAT 52 U/L and leukohemato casts. Vasculitis was extended to the upper limbs and to the trunk and since then the clinical evolution presented with episodes of fever and diarrhea, negative antinuclear antibodies and circulating immuno complexes in 0.140. The pleuropericardic effusion was self-limited. The AgHBV was negative and the anti-HCV was found to be positive. Skin biopsy revealed vasculitis with immuno complexes of the small vessels. The liver biopsy evidenced chronic hepatitis due to virus C with mild parenchymatous activity, moderate portal activity, and null fibrosis (knodell Index = 7). Finally, certain commentaries are made concerning the polymorphous clinical picture and the need for indicating viral markers to screen hepatitis C in subjects presenting with polyarthralgia and polyarthritis.
Palavras-chave : HEPATITIS C; HEPATITIS CHRONIC ACTIVE.