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Related Concept Videos

Hepatitis01:25

Hepatitis

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Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
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Viral Hepatitis I: Introduction01:28

Viral Hepatitis I: Introduction

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Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion...
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Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Cytomegalovirus Disease01:27

Cytomegalovirus Disease

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Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Cirrhosis II: Pathophysiology01:24

Cirrhosis II: Pathophysiology

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Cirrhosis is a progressive chronic liver injury caused by prolonged inflammation, excessive fibrotic remodeling, and impaired regeneration. Over time, repeated hepatic insults disrupt the liver’s architecture and function, leading to reduced blood flow, impaired bile drainage, and diminished metabolic capacity.Pathophysiology of cirrhosisCirrhosis arises from three main responses to chronic liver damage: inflammation, immune activation, and hepatocyte death. These processes lead to...
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Hepatitis C virus infection and its rheumatologic implications.

Zeynel A Sayiner1, Uzma Haque1, Mohammad U Malik1

  • 1The authors are affiliated with the Johns Hopkins School of Medicine in Baltimore, Maryland. Dr Sayiner is a visiting research fellow in the Section of Gastroenterology and Hepatology. Dr Haque is an assistant professor in the Section of Rheumatology. Dr Malik is a research fellow in the Section of Gastroenterology and Hepatology. Dr Gurakar is the medical director of the Liver Transplant Program and an associate professor of medicine in the Section of Gastroenterology and Hepatology.

Gastroenterology & Hepatology
|July 3, 2014
PubMed
Summary

Chronic hepatitis C virus (HCV) infection often presents with autoimmune disorders and rheumatic symptoms. Differentiating these from primary rheumatologic conditions is crucial for accurate diagnosis and treatment.

Keywords:
Hepatitis C virusautoimmune diseaserheumatologic implication

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Area of Science:

  • Hepatology
  • Rheumatology
  • Immunology

Background:

  • Extrahepatic manifestations are common in chronic hepatitis C virus (HCV) infection.
  • Many of these are autoimmune disorders, increasing patient mortality and morbidity.
  • HCV symptoms can overlap with rheumatic diseases, complicating diagnosis.

Purpose of the Study:

  • To highlight the importance of distinguishing HCV-related symptoms from new rheumatologic conditions.
  • To address the diagnostic challenges posed by overlapping symptoms and treatment effects.

Main Methods:

  • Review of clinical presentations in patients with chronic HCV.
  • Analysis of overlapping symptoms between HCV and rheumatic diseases (arthralgia, myalgia, arthritis, vasculitis).
  • Consideration of serologic abnormalities and treatment impacts (e.g., interferon therapy).

Main Results:

  • HCV infection frequently leads to autoimmune and rheumatic manifestations.
  • Similarities in symptoms (arthralgia, myalgia, arthritis) and serology exist between HCV and rheumatologic diseases.
  • HCV treatments can exacerbate rheumatic symptoms, further confounding clinical assessment.

Conclusions:

  • Accurate differentiation between HCV-related symptoms and de novo rheumatologic disease is essential.
  • Clinical vigilance is required to manage patients with chronic HCV and overlapping rheumatologic conditions.
  • Understanding these complexities improves patient outcomes and treatment strategies.