Peripheral neuropathy in essential mixed cryoglobulinaemia.

Gemignani, F; Pavesi, Giovanni; Fiocchi, A.; Manganelli, P; Ferraccioli, G; Marbini, A

doi:10.1136/jnnp.55.2.116

Cited by 62 publications

(35 citation statements)

References 30 publications

(17 reference statements)

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“…A p roximadamente 34% dos pacientes se queixaram de parestesias, principalmente nos membros superiores. A ENMG diagnosticou mononeuropatia múltipla em 11 (14,1%, IC95% 7,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)2) pacientes e síndro m e do túnel do carpo em 4 (5,1%). Conclusão: C o m p rometimento dos nervos periféricos é comum em pacientes com VHC, sendo neuropatia múltipla a apresentação mais comumente diagnosticada pela ENMG.…”

Section: Resumo -I N T Roduçãounclassified

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Peripheral neuropathy in patients with hepatitis virus C infection in the Amazon region

Gomes

Nora

Marquezini

et al. 2006

Arq. Neuro-Psiquiatr.

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-Introduction: Hepatitis virus C (HCV) infection is considered a health problem in the State of A c re localized in the Brazilian Amazon which has a prevalence rate of 5.9%. Peripheral neuropathy is a common extra-hepatic manifestation in patients with HCV. Objective: To determine the prevalence of peripheral neuropathies using clinical and neurophysiological parameters. Method: A cross sectional study was perf o rmed in patients assisted by a specialized center of infectious diseases in the State of Acre . All patients completed a clinicoepidemiological questionnaire, physical examination and nerve conduction studies (NCS). Results: We studied 78 patients with mean age 45.5 years (range from 10 to 76 years), two thirds were male, 51% had at least 8 years of formal education and 96% lived in the capital city of A c re State. Roughly 34% of patients complained about paresthesias mainly in upper limbs. The NCS diagnosed multiple mononeuropathy in 11 (14.1%; IC95% 7.6-23.2) patients and carpal tunnel syndrome in 4 (5.1%) patients. Conclusion: Subclinical involvement of peripheral nerves seems common in patients with H C V, with multiple mononeuropathy the main manifestation of nerve injury in this region as suggested by electrophysiological studies.KEY WORDS: hepatitis virus C, HCV, peripheral neuro p a t h y, nerve conduction studies, Amazon re g i o n , prevalence. N e u ropatia periférica em pacientes com infecção pelo vírus C da hepatite na região amazônica RESUMO -I n t rodução:A infecção pelo vírus da hepatite C (VHC) é considerada um problema de saúde pública no Estado do Acre com uma prevalência de 5,9%. Neuropatia periférica é uma manifestação extrahepática comum em pacientes com VHC. Objetivo: Determinar a prevalência de neuropatias periféricas através de parâmetros clínicos e neuro f i s i o l ó g i c o s . Método: Foi realizado estudo transversal em pacientes atendidos em uma clínica especializada de doenças infecciosas do Estado do Acre. Todos os pacientes foram submetidos a um questionário clínico-epidemiológico, exame físico e eletro n e u romiografia (ENMG). Resultados: Foram estudados 78 pacientes, com idade média de 45,5 anos (10 a 76), dois terços eram do sexo masculino, 51% tinha pelo menos 8 anos de educação formal e 95% moravam na capital do Estado. A p roximadamente 34% dos pacientes se queixaram de parestesias, principalmente nos membros superiores. A ENMG diagnosticou mononeuropatia múltipla em 11 (14,1%, IC95% 7,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)2) pacientes e síndro m e do túnel do carpo em 4 (5,1%). Conclusão: C o m p rometimento dos nervos periféricos é comum em pacientes com VHC, sendo neuropatia múltipla a apresentação mais comumente diagnosticada pela ENMG.

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Section: Resumo -I N T Roduçãounclassified

“…Usually the peripheral nervous system involvement is described as a sensory -m o t o r, distal polyneuropathy often with cryoglobulinemia 4,12 , but isolated mononeuro p a t h y, such as carpal tunnel s y n d rome or multiple mononeuropathy seem comm o n 1 2 , 1 3 , but studies of large cohorts of patients without cryoglobulinemia are still needed 11 .…”

mentioning

confidence: 99%

Peripheral neuropathy in patients with hepatitis virus C infection in the Amazon region

Gomes

Nora

Marquezini

et al. 2006

Arq. Neuro-Psiquiatr.

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“…Peripheral neuropathy, presumably caused by vasculitis, is rarely associated with clinically significant presentation (25). However, electromyographic and nerve conduction studies have revealed the presence of peripheral neuropathy in 70-80% of patients with mixed cryoglobulinemia (26)(27)(28).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Cryoglobulinemia (Review)

Takada

Shimizu²,

Hadano³

et al. 2012

Mol Med Report

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Abstract.Cryoglobulins are immunoglobulins that precipitate at low temperatures and redissolve upon rewarming. Cryoglobulinemia refers to the presence of circulating cryoglobulins in serum, and generally leads to a systemic inflammatory syndrome characterized by fatigue, arthralgia, purpura, neuropathy and glomerulonephritis. The disease mainly involves small to medium-sized blood vessels and causes vasculitis due to cryoglobulin-containing immune complexes. Cryoglobulinemia is classified into three types (I, II and III) on the basis of immunoglobulin composition. Predisposing conditions include lymphoproliferative disease, collagen disease and hepatitis C virus (HCV) infection. The diagnosis of cryoglobulinemic syndrome is predominantly based on the laboratory demonstration of serum cryoglobulins. Treatment is often directed towards the underlying disease state. For patients with chronic HCV infection, anti-viral therapy is indicated. Intense immunosuppressive or immunomodulatory therapy, including steroids, plasmapheresis and cytotoxic agents, is reserved for organ-threatening or recalcitrant disease. In this review, we discuss the clinical characteristics of the three types of cryoglobulinemia.

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“…Cryoglobulinemia is a condition characterized by serum proteins reversibly precipitating at low temperatures. A polyneuropathy, mainly of a sensory type, with signs of axonal degeneration, or a multiple mononeuropathy is seen in 7–50% of the patients [51, 52, 53]. Rheological alterations are seen in 60% of the patients [54].…”

Section: Clinical Ischemic Neuropathymentioning

confidence: 99%