Autoimmune interstitial lung disease and hepatitis C, an interesting association: Two case reports
Bibliographic record
Abstract
The hepatitis C virus (HCV) is a hepatotropic and lymphotropic virus. Its infection generates a chronic stimulus to the immune system, giving rise to a wide range of systemic diseases with rheumatological, hematological, neurological, renal, and pulmonary manifestations. Interstitial lung disease (ILD) is one of the most common and harmful direct effects of chronic HCV infection in the lung. However, polyarthralgia and arthritis are the most common rheumatic conditions associated with this infection. There are also less common ones, such as myopathies, including anti-synthetase syndrome (ASS). Although immune syndromes are common in patients with chronic HCV infection, their pathogenesis for some illnesses is often unclear. This case report discusses the association between ILD, hepatitis C, and rheumatologic diseases. We cover clinical manifestations, theories of pathogenesis, and the importance of selecting appropriate treatment for these patients. Two clinical cases are presented, both diagnosed with ILD associated autoimmune diseases in patients with HCV infection. The first case is a 76-year-old man with progressive dyspnea, dry cough, muscle weakness, and joint pain in both hands. Physical examination revealed dry velcro-type crackles and the presence of clubbing. Laboratory studies showed a hepatitis C viral load detectable by PCR, positive rheumatoid factor (RF), and anti-citrullinated peptide (anti-CCP). Chest CT scan showed a usual interstitial pneumonia pattern (UIP). Therefore, this patient was diagnosed with ILD and concomitant rheumatoid arthritis (RA) due to HCV infection. The second case is a 44-year-old woman complaining of dry cough and dyspnea, chest tightness, odynophagia, itching, and nasal congestion. On physical examination, bilateral subscapularis fine crackles, mechanic's hands. Blood laboratory analyses revealed a positive hepatitis C antibody test with hepatitis C virus viral load undetectable by PCR, RF: (+), anti-Ro-52 (+); anti-PL-12 (+), anti-Ro/SSA 52 (+). Chest CT scan showed a pattern of organizing pneumonia (OP). As a result, we diagnosed the patient with ILD, ASS, and past infection with the HCV. HCV and autoimmune diseases affect multiple systems, with lung involvement being a poor prognosis in both cases. Our case reports demonstrate positive outcomes in treating challenging diseases through close patient monitoring and individualized treatment decisions based on their needs, despite the absence of treatment guidelines for these patients.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".