What are signs of decompensated liver disease in patients with hepatitis C (hep C) infection?

Updated: Oct 07, 2019
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: BS Anand, MD  more...
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Most patients with hepatitis C virus (HCV) infection do not have abnormal physical examination findings until they develop portal hypertension or decompensated liver disease. One exception is patients with extrahepatic manifestations of HCV infection, such as porphyria cutanea tarda or necrotizing vasculitis. Signs in patients with decompensated liver disease include the following:

  • Hand signs: Palmar erythema, Dupuytren contracture, asterixis, leukonychia, clubbing
  • Head signs: Icteric sclera, temporal muscle wasting, enlarged parotid, cyanosis
  • Fetor hepaticus
  • Gynecomastia, small testes
  • Abdominal signs: Paraumbilical hernia, ascites, caput medusae, hepatosplenomegaly, abdominal bruit
  • Ankle edema
  • Scant body hair
  • Skin signs: Spider nevi, petechiae, excoriations due to pruritus

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