RESUMEN
The hepatic consequences of an infection with the hepatitis C virus (HCV) are well recognised, but extrahepatic manifestations of HCV may be just as severe. Here we have reviewed various extrahepatic manifestations of HCV such as mixed cryoglobulinemia, lymphoma, metabolic features and neurologic consequences and we discuss pathogenesis and management of these clinical problems. We concluded with important aspects of therapy with novel anti-HCV agents and its effects on extrahepatic manifestations.
Asunto(s)
Enfermedades Cardiovasculares/virología , Crioglobulinemia/virología , Diabetes Mellitus Tipo 2/virología , Hepacivirus/patogenicidad , Hepatitis C Crónica/complicaciones , Linfoma/virología , Síndrome Metabólico/virología , Antivirales/uso terapéutico , Aterosclerosis/virología , Índice de Masa Corporal , Disfunción Cognitiva/virología , Medicina Basada en la Evidencia , Hepacivirus/efectos de los fármacos , Humanos , Resistencia a la Insulina , Resultado del Tratamiento , Replicación ViralRESUMEN
Achalasia is a rare disorder, whose diagnostic Gold standard is high-resolution cesophageal manometry. The proposed treatment must take into account the patient's health condition and the type of achalasia determined by HRM. Heller's laparoscopic myotomy and pneumatic dilation are the first line treatments for most of the patients, whereas Botulinum toxin injections and pharmacologic therapy are only indicated for patients with a high surgical risk who cannot undergo first line treatments. Peroral endoscopic myotomy (POEM) is a recent and promising endoscopic technique reserved for expert endoscopy centers, whose exact role is still to be determined by randomized prospective studies. Oesophagectomy has only a marginal role in rare patients with extremely advanced achalasia or at risk of neoplastic degeneration.