Ask the Expert: The Relation Between Arthritis, Hepatitis C and Fibromyalgia

Mark Borigini, M.D. Health Pro
  • Question: I have a severe case of Hepatitis C from a blood transfusion in 1987 during emergency surgery. I've been on the Peg-combo 3x's and I have cirrhosis - my last biopsy yielded Stage 4, grade 2. I have been sober in AA for more than 19 years. No fatty infiltrates were found on my biopsy.

    I have a positive RH factor and the sed rate blood test has been both positive and negative; however, I believe I have HCV Arthritis. I have very few bone spurs but many joints involved. I had arthroscopic ankle surgery in July and it was a failure - I am extremely hypermobile anyway. I have severe pain in my hips, back, and wrists, and I wear wrist braces just about 24/7. I've been screened for Marfan syndrome and the results are negative; however, I do have fibromyalgia.
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    I've been told I have RA and have been told I haven't - I'm now housebound with arthritis, I have a leg brace, I can't get out of bed in the mornings and I have extreme pain that opioids don't come close to helping (or I'm not getting an adequate dose). I can't take any NSAIDS, nor can I take anything that has hepatotoxic side effects. All I want is quality of life.

    I've been referred to a VA clinic 250 miles from my home - will it be worth the wear & tear to see a rheumatologist?

    Dr. Borigini: Hepatitis C can be associated with an arthritis which can look very much like rheumatoid arthritis; it can also cause arthralgias, which is joint pain without swelling. And of course many illnesses can be associated with so-called secondary fibromyalgia. Spurs are associated with osteoarthritis, otherwise known as degenerative joint disease.

    It is very difficult to determine the exact origin of all the pains described in this communication, so I do believe that a consultation with a rheumatologist would be a reasonable next step – perhaps you can look into whether or not there is one closer to you. There are drugs that might ease the chronic pain described here which are fairly safe on the liver.




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Published On: October 12, 2006