ABSTRACT: Given the high prevalence of chronic hepatitis C virus (HCV) infection, its clinical sequelae account for a significant proportion
of patients presenting to gastroenterologists and hepatologists. Whereas the hepatic manifestations of hepatitis C are well
described, including hepatitis, cirrhosis, and the development of hepatocellular carcinoma, the extrahepatic manifestations,
though common, are less well appreciated. Although nonspecific, fatigue and arthralgias are very common in those with chronic
hepatitis C. Extrahepatic syndromes have been reported in as much as 36% of HCV patients, but the exact prevalence is not
known. Patients with these syndromes can be divided into those with a high degree of association and those with a more moderate
or mild association with HCV. The most prevalent extrahepatic diseases with the highest degree of association with HCV are
the essential mixed cryoglobulins with skin, neurologic, renal, and rheumatologic complications. Non-cryoglobulin diseases
with a less definite relationship to HCV include systemic vasculitis, splenic lymphoma, porphyria cutanea tarda, and the sicca
syndromes. This article highlights the pathophysiology and clinical manifestations of these disorders.
Current Gastroenterology Reports 04/2012; 8(1):53-59.