R H Khonsari1, S Maylin2, P Nicol3, M Martinot-Peignoux4, A Créange5, C Duyckaerts6, C Bertolus3. 1. Service de Chirurgie Maxillofaciale et Stomatologie, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France ; UPMC Université Paris 06, 75005 Paris, France ; Laboratoire de Neuropathologie Raymond-Escourolle, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France. 2. Service de Microbiologie, Hôpital Beaujon, Clichy, France. 3. Service de Chirurgie Maxillofaciale et Stomatologie, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France ; UPMC Université Paris 06, 75005 Paris, France. 4. INSERM U-773, Centre de recherche biomédicale Bichat-Beaujon CRB3, Université Paris VII, Clichy, France. 5. Service de Neurologie, Hôpital Henri Mondor, Créteil, France. 6. UPMC Université Paris 06, 75005 Paris, France ; Laboratoire de Neuropathologie Raymond-Escourolle, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
Abstract
INTRODUCTION: Hepatitis C virus (HCV) infections are associated with extrahepatic manifestations in 40-75 % of cases. Sialitis and secondary Sjögren syndrome are well characterized complications of chronic HCV infections but the mechanisms (primary or secondary) leading to xerostomia are not understood. Similarly, brain lesions due to HCV can be primary or secondary but the pathology of primary HCV-related brain lesions is not well described. CASE REPORT: We report the postmortem case of a 60-year old patient initially presenting with sicca syndrome and dementia. HCV was identified in the brain but not in the salivary glands using transcription-mediated amplification (TMA). Focal sialitis was found in submandibular glands. Neuropathological examination revealed the presence of multiple dot-sized demyelination foci. CONCLUSION: Sicca syndrome is a common concern in chronic HCV infections and may be due to secondary immune mechanisms (we could not isolate HCV in salivary gland tissues). TMA had never been applied to the detection of viruses in salivary glands and neural tissues and proves to be a promising technique. Neuropathological reports in HCV infections are rare and the lesions we report may be the first characterization of the direct effect of HCV on brain cells. More cases are needed to define the full spectrum of lesions potentially caused by the direct action of the HCV on salivary glands and neural tissues.
INTRODUCTION:Hepatitis C virus (HCV) infections are associated with extrahepatic manifestations in 40-75 % of cases. Sialitis and secondary Sjögren syndrome are well characterized complications of chronic HCV infections but the mechanisms (primary or secondary) leading to xerostomia are not understood. Similarly, brain lesions due to HCV can be primary or secondary but the pathology of primary HCV-related brain lesions is not well described. CASE REPORT: We report the postmortem case of a 60-year old patient initially presenting with sicca syndrome and dementia. HCV was identified in the brain but not in the salivary glands using transcription-mediated amplification (TMA). Focal sialitis was found in submandibular glands. Neuropathological examination revealed the presence of multiple dot-sized demyelination foci. CONCLUSION:Sicca syndrome is a common concern in chronic HCV infections and may be due to secondary immune mechanisms (we could not isolate HCV in salivary gland tissues). TMA had never been applied to the detection of viruses in salivary glands and neural tissues and proves to be a promising technique. Neuropathological reports in HCV infections are rare and the lesions we report may be the first characterization of the direct effect of HCV on brain cells. More cases are needed to define the full spectrum of lesions potentially caused by the direct action of the HCV on salivary glands and neural tissues.
Authors: Wolf Peter Hofmann; Volker Dries; Eva Herrmann; Barbara Gärtner; Stefan Zeuzem; Christoph Sarrazin Journal: J Clin Virol Date: 2005-04 Impact factor: 3.168
Authors: C A Scott; C Avellini; L Desinan; M Pirisi; G F Ferraccioli; P Bardus; C Fabris; L Casatta; E Bartoli; C A Beltrami Journal: Histopathology Date: 1997-01 Impact factor: 5.087
Authors: M Castro Ferreiro; M Hermida Prieto; S Barral Rodríguez; R Laredo Vázquez; A Castro Iglesias; P Diz Dios Journal: J Oral Pathol Med Date: 2002-02 Impact factor: 4.253
Authors: Manuel Ramos-Casals; Veronique Loustaud-Ratti; Salvatore De Vita; Margit Zeher; Jose-Angel Bosch; Eric Toussirot; Francisco Medina; Jose Rosas; Juan-Manuel Anaya; Josep Font Journal: Medicine (Baltimore) Date: 2005-03 Impact factor: 1.889