Presentation and outcome of gastrointestinal involvement in hepatitis C virus-related systemic vasculitis: a case-control study from a single-centre cohort of 163 patients.

Abstract

BACKGROUND:

During primary systemic vasculitides gastrointestinal (GI) involvement is associated with a poor outcome, leading to the use of immunosuppressive therapy. The significance of GI involvement during hepatitis C virus (HCV)-related systemic vasculitis has never been evaluated.

OBJECTIVE:

To evaluate the significance of GI involvement during HCV-related systemic vasculitis in the antiviral therapy era.

METHODS:

Data from 163 patients were retrospectively reviewed to describe the presentation and outcome of patients with HCV-related systemic vasculitis with GI involvement (GI+), and to compare them with patients without GI involvement (GI-).

RESULTS:

GI manifestations were present in 12 (7.4%) patients. Abdominal pain was consistently present in GI+ patients, and half of patients presented with surgical abdomen and/or intestinal bleeding. GI+ compared to GI- patients had more frequent renal (75% vs 30%; p=0.003) and cardiac involvement (25% vs 2%; p=0.006), medium-vessel vasculitis (67% vs 22%; p=0.003) and higher mixed cryoglobulinaemia levels (2.2 g/l vs 1.2 g/l; p=0.07). After treatment, GI+ and GI- patients had similar rates of overall clinical response of the vasculitis and immunological and virological responses. HCV-MC vasculitis patients with GI involvement did not have poorer overall survival than those without.

CONCLUSION:

GI involvement is a rare manifestation of HCV-related vasculitis, associated with acute-onset and life-threatening manifestations. In contrast with primary vasculitides, GI+ patients do not seem to have poorer overall survival than GI- patients.

• Authors: Benjamin Terrier, David Saadoun, Damien Sène, Sami Scerra, Lucile Musset, Patrice Cacoub
• Journal: Gut (Gut) Vol. 59 Issue 12 Pg. 1709-15 (Dec 2010) ISSN: 1468-3288 [Electronic] England
• PMID: 20841367 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents

Topics

• Abdominal Pain (virology)
• Acute Disease
• Aged
• Antiviral Agents (therapeutic use)
• Epidemiologic Methods
• Female
• Gastrointestinal Diseases (diagnostic imaging, virology)
• Gastrointestinal Hemorrhage (virology)
• Hepatitis C (complications, drug therapy)
• Humans
• Male
• Middle Aged
• Prognosis
• Systemic Vasculitis (diagnostic imaging, virology)
• Tomography, X-Ray Computed
• Treatment Outcome