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ANSWER TO QUESTION OF THE WEEK: (6/18/06)
Yes. Chronic hepatitis C may cause disorders in organs other than the liver, known as extrahepatic manifestations. This is partly due to the fact that other parts of the body are often caught in the crossfire when the immune system fights against an HCV infection. Most of these extrahepatic manifestations are due to immune-mediated diseases. However, HCV has also been found in various other parts of the body besides the liver, such as stomach, lymph glands, bone marrow, and brain. The severity of these exrahepatic manifestations does not correlate with the extent of damage found in the liver, the duration that one has had HCV, or the HCV viral load.
Inflammation of the kidney, known as glomerulonephritis, has been associated with chronic hepatitis C. People with glomerulnephritis have either blood ( hematuria) or excess more comonly excess protein (proteinuria) in their urine. Treatment of HCV with interferon often results in remission of this type of kidney disease. However, when interferon therapy is stopped, proteinuria typically returns. This often necessitates long-term interferon treatment.
Approximately 20% of patients with both HCV and cryoglobulinemia also have glomerulonephritis. Cryoglobulinemia (excess proteins in the blood) presents with purpura, joint aches (known as arthralgias), and weakness. Cryoglobulinemia may also affect the kidneys, brain, and nerves. Although cryoglobulinemia has been found in approximately 40 percent of all individuals with chronic hepatitis C, only about half of these people experience symptoms related to cryoglobulinemia.
Finally, diabetes—elevated blood sugar (glucose) levels—has been found to be present in many people with chronic hepatitis C. Diabetes can also cause kidney disorders.
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Dr. Palmer is an internationally renowned hepatologist who has been practicing medicine since 1985. She maintains perhaps the largest private medical practice devoted to liver disease in the United States. Dr. Palmer graduated from Columbia University with a B.A. and was trained in hepatology (as well as medical school) at the Mount Sinai School of Medicine in New York City. She has authored numerous scientific publications in the field of hepatology in such peer-reviewed journals as Hepatology, Gastroenterology, Seminars of Liver Disease, Transplantation and Archives of Internal Medicine.
She is frequently called upon by the media for her opinion on various topics related to liver disease. Dr. Palmer has appeared many times on television as a liver disease expert and has been quoted in such publications as TIME magazine, Cosmopolitan magazine, Prevention magazine, the Los Angeles Times, and Newsday. She also has appeared in numerous videos and CD-Roms aimed at educating doctors and the public about hepatitis C and other liver diseases, such as primary biliary cirrhosis.Dr. Palmer lectures to the medical and general public on liver disease-related topics on a regular basis. She also serves as a liver consultant to five major pharmaceutical companies.
Dr. Palmer is a board member of the New York chapter of the American Liver Foundation, and she sits on the nutrition subcommittee of the national chapter of the American Liver Foundation, the medical advisory board of the Latino Organization for Liver Awareness (LOLA) and the medical advisory board of the Primary Biliary Cirrhosis Organization (PBCers). She has also been a member of the practice guidelines committee of the American Association for the Study of Liver Disease(AASLD) and currently sits on the enduring educational materials committee of AASLD.
Dr. Palmer has performed trials on various experimental medication for the treatment of hepatitis. She is currently conducting research on new therapies for liver disease, specifically in the area of hepatitis C.
Her practice is located on Long Island, New York. (Main office located at: 1097 Old Country Road, Suite 104, Plainview, N.Y. 11803.
Satellite office located at 500 Portion Rd. Lake Ronkonkoma, N.Y. 11779)
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If you are interested in arranging an appointment with Melissa Palmer, M.D., please call (516) 939-2626.
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