Chronic Sialadenitis revealing hepatitis C: a case report

One 53-year-old male was referred with a history of sensitive peripheral neuropathy and Raynaud disease leading to suspect a Sjögren syndrome (SS). Labial salivary gland biopsy shown the classical features of chronic lymphocytic sialadenitis. As clinical and immunologic tests were positive, we conclude to a chronic lymphocytic sialadenitis simulating SS. Enzyme immunoassay and recombinant immunoblot were positive to HCV. Circulating HCV-RNA was detected by PCR. Liver biopsy revealed chronic persistent hepatitis. In one second biopsy, RNA was extracted. PCR amplification and southern blot hybridization for HCV-RNA were performed. After a 8-month treatment by interferon alpha, HCV-RNA was no longer detected in the serum. There was an objective improvement of the Schirmer test. The detection of HCV-RNA in the salivary glands of a Sjögren like syndrome-patient suggests that a direct infection of the salivary glands by HCV could play an important role in the pathogenesis of HCV related sialadenitis.