Extrahepatic Manifestations in Chronic Hepatitis B – the Experience of the Iasi Infectious Diseases Hospital between 2012-2014

EXTRAHEPATIC MANIFESTATIONS IN CHRONIC HEPATITIS B – THE EXPERIENCE OF THE IASI INFECTIOUS DISEASES HOSPITAL BETWEEN 2012-2014 (Abstract): There are numerous extrahepatic syndromes associated with HBV infection: vascular, renal, and cutaneous manifestations, essential mixed cryoglobulinemia, and neurological phenomena. Aim: This study proposes an approach to the extrahepatic manifestations of chronic hepatitis B as it has been shown that the persistent production of immune complexes induces extrahepatic lesions. Material and Methods: In the interval 2012-2014 180 cases of chronic hepatitis B were admitted to the Iasi Infectious Diseases Hospital. Results: The mean age of the study patients was 41 years, most patients being male (65%) and living in urban areas (70%). Cutaneous manifestations of chronic HBV infection were present in 62% of patients and consisted in: rash (25%), Gianotti-Crosti syndrome (15%), cryoglobulinemia (21.11%) and Henoch-Schonlein purpura (12.22%). Panarteritis nodosa (PAN) with a prevalence of 9%, and renal manifestations -glomerulonephritis (2.77%) and nephrotic syndromewere present. Also reported were neurological manifestations (peripheral neuritis, Guillain Barre syndrome) in 11.1% of the cases, endocrine manifestations (impaired glucose metabolism, and hypothyroidism) in 19.4%, hematological (thrombocytopenia, hemolytic anemia, aplastic anemia) and cardiovascular manifestations. Conclusions: In our group of patients the extrahepatic manifestations often complicated the course of chronic HBV infection with a wide range clinical manifestations involving many organs or systems (skin, joints, nervous, renal, cardiovascular and hematologic systems).