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Morphologic features of extrahepatic manifestations of hepatitis C virus infection.

Ko HM, Hernandez-Prera JC, Zhu H, Dikman SH, Sidhu HK, Ward SC, Thung SN - Clin. Dev. Immunol. (2012)

Bottom Line: The most documented of these entities is mixed cryoglobulinemia.Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis.This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

View Article: PubMed Central - PubMed

Affiliation: The Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA. mabel.ko@mssm.edu

ABSTRACT
Cirrhosis and hepatocellular carcinoma are the prototypic complications of chronic hepatitis C virus infection in the liver. However, hepatitis C virus also affects a variety of other organs that may lead to significant morbidity and mortality. Extrahepatic manifestations of hepatitis C infection include a multitude of disease processes affecting the small vessels, skin, kidneys, salivary gland, eyes, thyroid, and immunologic system. The majority of these conditions are thought to be immune mediated. The most documented of these entities is mixed cryoglobulinemia. Morphologically, immune complex depositions can be identified in small vessels and glomerular capillary walls, leading to leukoclastic vasculitis in the skin and membranoproliferative glomerulonephritis in the kidney. Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis. This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

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Diabetic Nephropathy: extensive mesangial expansion is seen, with rounded acellular mesangial nodules (Kimmelstiel-Wilson nodules) (hematoxylin-eosin and PAS, original magnification ×400).
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fig9: Diabetic Nephropathy: extensive mesangial expansion is seen, with rounded acellular mesangial nodules (Kimmelstiel-Wilson nodules) (hematoxylin-eosin and PAS, original magnification ×400).

Mentions: The microscopic features include diffuse mesangial sclerosis with thickening of glomerular capillary walls and thickening of the tubular basement membranes. Nodular lesions, characterized as eosinophilic material within the mesangium first described by Kimmelstiel and Wilson in 1936, may be seen (Figure 9) [39]. Microaneurysms of glomerular capillary loops may precede the development of large nodules [22, 40]. On IF, linear staining along the glomerular capillary walls with IgG is seen [40, 41].


Morphologic features of extrahepatic manifestations of hepatitis C virus infection.

Ko HM, Hernandez-Prera JC, Zhu H, Dikman SH, Sidhu HK, Ward SC, Thung SN - Clin. Dev. Immunol. (2012)

Diabetic Nephropathy: extensive mesangial expansion is seen, with rounded acellular mesangial nodules (Kimmelstiel-Wilson nodules) (hematoxylin-eosin and PAS, original magnification ×400).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3420144&req=5

fig9: Diabetic Nephropathy: extensive mesangial expansion is seen, with rounded acellular mesangial nodules (Kimmelstiel-Wilson nodules) (hematoxylin-eosin and PAS, original magnification ×400).
Mentions: The microscopic features include diffuse mesangial sclerosis with thickening of glomerular capillary walls and thickening of the tubular basement membranes. Nodular lesions, characterized as eosinophilic material within the mesangium first described by Kimmelstiel and Wilson in 1936, may be seen (Figure 9) [39]. Microaneurysms of glomerular capillary loops may precede the development of large nodules [22, 40]. On IF, linear staining along the glomerular capillary walls with IgG is seen [40, 41].

Bottom Line: The most documented of these entities is mixed cryoglobulinemia.Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis.This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

View Article: PubMed Central - PubMed

Affiliation: The Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA. mabel.ko@mssm.edu

ABSTRACT
Cirrhosis and hepatocellular carcinoma are the prototypic complications of chronic hepatitis C virus infection in the liver. However, hepatitis C virus also affects a variety of other organs that may lead to significant morbidity and mortality. Extrahepatic manifestations of hepatitis C infection include a multitude of disease processes affecting the small vessels, skin, kidneys, salivary gland, eyes, thyroid, and immunologic system. The majority of these conditions are thought to be immune mediated. The most documented of these entities is mixed cryoglobulinemia. Morphologically, immune complex depositions can be identified in small vessels and glomerular capillary walls, leading to leukoclastic vasculitis in the skin and membranoproliferative glomerulonephritis in the kidney. Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis. This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

Show MeSH
Related in: MedlinePlus