Chronic Hepatitis C is Associated with Adrenal Tumors

Abstract

AIM: Increased serum levels of insulin growth factor (IGF) and insulin have been reported in patients with chronic hepatitis C. Insulin and IGF-1 have also been associated with increased growth of adrenal cells in culture. These observations suggest that both IGF and insulin can trigger adrenal tumorigenesis. Adrenal tumors have been reported in a series of patients with chronic hepatitis C; accordingly, the aim of this study was to explore further this potential association. METHODS: Patients with a diagnosis of adrenal tumors over the past ten years were identified and their records reviewed for evidence of chronic hepatitis C. The control group was comprised of age-matched subjects who had had a CT or MRI of the abdomen during the same study period, and had documentation of hepatitis C status. RESULTS: Twenty three patients with adrenal tumors were identified. Fifteen of these patients (65.2%) had hepatitis C antibody in serum; eleven (47.8%) of these had hepatitis C RNA, confirming chronic hepatitis C (CHC). In the control group, in contrast, only one of twenty-three patients (4.3%) had hepatitis C antibody in serum, which was significantly lower than in the study group (p value<0.0005). CONCLUSION: There is an association between chronic hepatitis C and adrenal tumors. Adrenal tumors may be one of the extrahepatic manifestations of this viral infection. The recognition of this association by clinicians will dramatically change the approach to patients with chronic hepatitis C and manifestations, even subtle, of functional adrenal tumors, which require diagnostic evaluation and treatment.