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Pruritus as a Presenting Symptom of Chronic Hepatitis C

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Abstract

Pruritus is a common symptom in cholestaticliver disease but is rare in chronic hepatitis C. Eightpatients with chronic hepatitis C and severe prurituswere compared with regard to biochemical, serological, and histological features to eight diseasecontrols with primary biliary cirrhosis and seven withcirrhosis due to hepatitis C. Among those with severepruritus associated with chronic hepatitis C, serum aminotransferases were raised in all, alkalinephosphatase in four, and γ-glutamyl-transpeptidaselevels in all except one. Serum cholylglycine levelswere elevated in seven of eight patients. Liver biopsies showed moderate to severe fibrosis inall patients and cirrhosis in five. Compared to controlsubjects with cirrhosis due to hepatitis C but nopruritus, ductopenia, and cholestatic changes were prominent, although less so than in controlswith primary biliary cirrhosis. Chronic hepatitis C withmoderate to severe fibrosis may result in low-gradecholestasis with pruritus, possibly in association with bile duct disappearance.

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Authors
  1. Siew-Cheng Chia
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  2. Nora V. Bergasa
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  3. David E. Kleiner
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  4. Zachary Goodman
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  5. Jay H. Hoofnagle
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  6. Adrian M. Di Bisceglie
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Chia, SC., Bergasa, N.V., Kleiner, D.E. et al. Pruritus as a Presenting Symptom of Chronic Hepatitis C. Dig Dis Sci 43, 2177–2183 (1998). https://doi.org/10.1023/A:1026646017851

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