Rheumatic syndromes during the course of HCV infection

The aim of the study was to evaluate clinical features and serological abnormalities in patients(pts) with rheumatological symptoms in the course of HCV infection (5 pts) and interferon-alpha treatment (2 pts). The diagnosis of hepatitis C was based on positive history on jaundice and risk factors of HCV infection, abnormal liver laboratory tests, the presence of anti-HCV and HCV-RNA and on results of liver biopsy. Among the patients with rheumatological features in the course of HCV infection seropositive arthritis in 4 pts, leucocytoclastic vasculitis, clinical and serological manifestations of mixed cryoglobulinemia-in 3 pts were observed. Glomerulonephritis, Raynaud's phenomenon and antinuclear antibodies were found in 2 pts. Sjögren's syndrome with anti-Ro/La antibodies, polyneuropathy and myalgia were observed in single cases. The most frequent therapy were corticosteroids alone or in combination with chlorochine or azathioprine. Arthritis, leucocytoclastic vasculitis and serological abnormalities: antinuclear antibodies, rheumatoid factor and low complement were seen in 2 pts with rheumatological features after the IFN-alpha treatment of HCV infection. Myalgia and xerostomia with anti-Ro antibody were found in one patient; lupus-like disease with anti-dsDNA antibody and autoimmune thyroiditis-in one patient. The therapy of these two cases was to withdraw interferon-alpha.