Dupuytren's contracture, chronic liver disease and IgA immune complexes

Abstract

Contrary to previous reports, Dupuytren's contracture was found to be equally common in patients with alcoholic and non-alcoholic biopsy-proven liver disease (25% v 28%). Furthermore, in 69 patients with Dupuytren's contracture referred for surgical correction, there was no significant increase in either history of alcohol abuse or abnormality of liver function compared to a matched control group. Patients with Dupuytren's contracture were found to have increased levels of circulating IgA immune complexes compared to those without (p<0.05 for those with liver disease; p<O.OOI for thoseawaitingsurgical correction). Circulating immunoglobulins and immune complexes of other classes were similar between the groups with and without Dupuytren's contracture. These results suggest that the importance of alcohol has previously been exaggerated but that IgA immune complexes may be involved in the pathogenesis of the condition.

A Systematic Review and Meta-Analysis on the Strength and Consistency of the Associations between Dupuytren Disease and Diabetes Mellitus, Liver Disease, and Epilepsy

“…The sex distribution was reported in almost all articles. 36 , 47 Two additional articles were excluded because they reported incomplete data. 39 , 40 Thus, five articles entered the meta-analysis (Table 4 ).…”

Recognizing and treating cutaneous signs of liver disease

“…54 Although the exact cause of Dupuytren contracture is unknown, it appears to be associated with excess alcohol consumption and can be found in patients with alcoholic cirrhosis. 54,55 These patients often present with painless stiffness of the fingers, curling of fingers, and loss of motion in involved fingers. 54 Surgery in the form of limited fasciectomy has been curative in such patients.…”