| Abstract | Povijest su obilježile brojne epidemije žutice, prvi puta zabilježene u Kini prije 5000 godina. Razvojem tehnologije, od sredine dvadesetog stoljeća do danas, uspješno su identificirani i izolirani njihovi uzročnici te svrstani u skupine od A do E. Iako se virusni hepatitisi tradicionalno vežu za širok spektar jetrenih bolesti (od akutnog, fulminantnog i kroničnog hepatitisa do ciroze jetre i hepatocelularnog karcinoma), današnja saznanja sve više ukazuju na povezanost s razvojem brojnih bolesti izvan jetre. Ekstrahepatalne manifestacije, kao što su neurološki poremećaji, autoimuni fenomeni, kardiovaskularne komplikacije, dermatološke i reumatološke patologije, te druge sistemske bolesti, postaju sve značajnije područje istraživanja i kliničke prakse. Suvremena istraživanja ukazuju na kompleksnost interakcija između virusnih uzročnika i imunološkog sustava te njihov potencijalni štetni utjecaj na različite organske sustave. Primjerice, virus hepatitisa C je poznat po svojoj sposobnosti induciranja krioglobulinemije i bolesti autoimunog spektra, dok se virus hepatitisa E povezuje s brojnim neurološkim komplikacijama poput Guillain-Barréova sindroma. Učestalost ekstrahepatalnih manifestacija među virusnim hepatitisima i sklonost zahvaćanja pojedinih organskih sustava varira. Najviše slučajeva zabilježeno je u sklopu kronične infekcije hepatitisom C, potom hepatitisa B, E i A, dok izvanjetrene bolesti kao posljedica infekcije hepatitisom D još uvijek nisu primijećene. Ova šira percepcija virusnih hepatitisa kao sistemskih bolesti zahtijeva multidisciplinarni pristup u njihovoj dijagnostici, liječenju i prevenciji. Ovaj rad pobliže opisuje patofiziologiju, kliničku sliku, dijagnostiku i liječenje najčešćih ekstrahepatalnih manifestacija pojedinih virusnih hepatitisa, naglašavajući važnost ranog prepoznavanja i intervencije kako bi se smanjila njihova prevalencija i poboljšao ishod bolesnika. |
| Abstract (english) | History has been marked by numerous epidemics of jaundice, first recorded in China 5000 years ago. With the development of technology from the mid-20th century to the present, their causative agents have been successfully identified, isolated, and classified into groups A to E. Although viral hepatitis is traditionally associated with a wide range of liver diseases (from acute, fulminant, and chronic hepatitis to cirrhosis and hepatocellular carcinoma), current knowledge points to an increasing association with the development of numerous extrahepatic diseases. Extrahepatic manifestations, such as neurological disorders, autoimmune phenomena, cardiovascular complications, dermatological and rheumatological pathologies, and other systemic diseases, are becoming significant areas of research and clinical practice. Modern researches highlight the complexity of interactions between viral agents and the immune system and their potentially harmful impact on various organ systems. For example, hepatitis C virus is known for its ability to induce cryoglobulinemia and autoimmune diseases, while hepatitis E virus is associated with numerous neurological complications such as Guillain-Barré syndrome. The frequency of extrahepatic manifestations among viral hepatitis and the tendency to affect specific organ systems varies. The highest number of cases has been recorded in the context of chronic hepatitis C infection, followed by hepatitis B, E, and A, while extrahepatic diseases as a result of hepatitis D infection have not yet been observed. This broader perception of viral hepatitis as systemic diseases requires a multidisciplinary approach to their diagnosis, treatment, and prevention. This paper provides a detailed description of the pathophysiology, clinical presentation, diagnosis, and treatment of the most common extrahepatic manifestations of individual viral hepatitis, emphasizing the importance of early recognition and intervention to reduce their prevalence and improve patient outcomes. |
