Sjogren's syndrome in chronic hepatitis C: clinical features and diagnosis
- Authors: Chernetsova OV1,2, Lopatkina TN1,2, Popova IV1,2, Vorobyev AA1,2, Shipulina ОY.1,2, Safonova TN1,2, Ponomarev AB1,2
-
Affiliations:
- ММА им. И. М. Сеченова
- ЦНИИ эпидемиологии Минздрава РФ
- Issue: Vol 78, No 4 (2003)
- Pages: 33-37
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/29342
- ID: 29342
Cite item
Full Text
Abstract
Material and methods. The examination of 42 patients with SS and chronic HCV infection (mean age 44.3 ± 13.7 years) has detected signs of chronic hepatitis and hepatic cirrhosis, respectively, in 31 (71.4%) and 11 (26.2%) patients. "Dry syndrome" was diagnosed by criteria of European SS Study Group. LSG biopsy of the lower lip was conducted in 23 (54.7%) of 42 patients. Results. The "dry" syndrome in CHC ran subclinically in 73.8% patients. Apparent symptoms of SS were seen primarily in middle-aged and aged women with CHC history over 10 years. The first signs of SS occurred in 25 (59.5%) patients 2.9+3.1 years prior to diagnosis of hepatic disease. All the patients had xerostomy. Xerophthalmia was recorded 1.5 times less frequently. In 16 (47.1%) patients with CHC "dry eye" and in 6 (17.6%) patients dry keratoconjunctivitis were detected. Pathohistological changes of LSG were diagnosed in 21 (91.3%) of 23 patients with CHC. In the majority of cases (86.9%) the glands exhibited insignificant inflammatory infiltration and advanced fibrosis. LSG in CHC is characterized by fibrosis prevalence over cell infiltration. 83.3% CHC patients had SS and other extrahepatic lesions. SS was most evident in 28.6% CHC patients with cryoglobulinemia. Conclusion. Registration of SS symptoms in CHC patients depends on targeted examination of patients with chronic HCV infection. The severity of the symptoms correlates directly with the infection duration and age of the patient. LSG lesions in CHC patients with SS are characterized by fibrosis predomination over cell infiltration.
About the authors
O V Chernetsova
ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФМосква; ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФ
T N Lopatkina
ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФМосква; ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФ
I V Popova
ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФМосква; ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФ
A A Vorobyev
ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФМосква; ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФ
О Yu Shipulina
ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФМосква; ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФ
T N Safonova
ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФМосква; ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФ
A B Ponomarev
ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФМосква; ММА им. И. М. Сеченова; ЦНИИ эпидемиологии Минздрава РФ
References
- Васильев В. И. Болезнь Шегрена. Рус. мед. журн. 1998; 6 (18): 19-24.
- De Vita S., Sansonno D., Dolcetti R. et al. Hepatitis С virus within a malignant lymphoma lesion in the course of type II mixed cryoglobulinemia. Blood 1995; 86: 18-39.
- Arrieta J. J., Rodriguez-Inigo E., Casqueiro M. et al. Detection of hepatitis С virus replication by in situ hybridization in epithelial cells of anti-hepatitis С virus-positive patients with and without oral lichen planus. Hepatology 2000; 32: 97-103.
- Arrieta J. J., Rodriguez-Inigo E., Ortiz-Movilla N. et al. In situ detection of hepatitis С virus RNA in salivary glands. Am. J. Pathol. 2001; 158 (1): 259-264.
- Vitali C., Bombardieri S., Moutsopoulos H. M. et al. Assessment of the European classification criteria for Sjogren's syndrome in a series of clinically defined cases: results of a prospective multicentre study. The European Study Group on Diagnostic Criteria for Sjogren's Syndrome. Ann. Rheum. Dis. 1996; 55: 116-121.
- Menelaos N., Manoussakis M. D. Salivary gland diseases. Otolaryngol. Clin. N. Am. 1999; 32 (5): 843-860.
- Koike K., Moriya K., Ishibashi K. et al. Sialodenitis histologically resembling Sjogren syndrome in mice transgenic for hepatitis С virus envelope genes. Proc. Natl. Acad. Sci. USA 1997; 94 (1): 233-236.
- Игнатова Т. M., Апросина 3. Г., Серов В. В. и др. Внепеченочные проявления хронического гепатита С. Тер. арх. 1998; 70(11): 9-16.
- Юдина Ю. В. Синдром Шегрена: клиника, диагностика: Дис. ... канд. мед. наук. М.; 1976.
- Boscali A., Hatron P. Y., Canva-Delcambe V. et al. Sicca syndrome and hepatitis С virus infection: a Gougerot-Sjogren pseudo-syndrome? Rev. Med. Intern. 1996; 17 (5): 375-380.
- Scott С. A., Avellini C., Desinan L. et al. Chronic lymphocytic sialodenitis in HCV-related chronic disease: comparison of Sjogren's syndrome. Histopathology 1997; 30 (1): 41-48.
- Verbaan H., Carlson J., Eriksson S. et al. Extrahepatic manifestations of chronic hepatitis С infection and interrelationship between Sjogren's syndrome and hepatitis С in Swedish patients. J. Intern. Med. 1999; 245 (2): 127-132.
- Cacoub P., Renou C., Rosenthal E. et al. Extrahepatic manifestations associated with hepatitis С virus infection, a prospective multicenter study of 321 patients. Medicine (Baltimore) 2000; 79 (1): 47-56.
- Jonsson R., Skarstein K. Experimental models of Sjogren's syndrome. In: Theofilopoulos, Bona, eds. The molecular pathology of autoimmune diseases. Harwood Acad. Publ. Chur.; 2001.
- Jorgensen C., Legouffe M. C., Perney P. et al. Sicca syndrome associated with hepatitis С virus infection. Arthr. and Rheum. 1996; 39(7): 1166-1171.
![](/img/style/loading.gif)