RESEARCH - Diagnostic confusion caused by hepatitis C: hemochromatosis presenting as RA

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J Rheumatol. 1998 Dec;25(12):2459-63. Links

Diagnostic confusion caused by hepatitis C: hemochromatosis presenting as

rheumatoid arthritis.

Department of Medicine, University of Texas Health Science Center at San

, 78284-7868, USA.

We describe a patient with hemochromatosis and coexistent infection with the

hepatitis C virus who was initially thought to have rheumatoid arthritis.

His symptoms began at the age of 44 with pain of the hand joints, shoulders,

hips, and knees and a positive rheumatoid factor. Four years later, he

required replacement of both hips due to severe hip arthritis. Abnormalities

in liver function were noted early on, but they were attributed to infection

with the hepatitis C virus, detected serologically and by polymerase chain

reaction amplification in the blood. The correct diagnosis was delayed until

a decision to use methotrexate as treatment for his arthritis led to a liver

biopsy, which revealed increased iron deposition consistent with

hemochromatosis, confirmed by genetic testing, which revealed that the

patient was homozygous for the C282Y mutation of the HLA-H gene.

PMID: 9858446

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=9858446

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