Peripheral Neuropathy in Japanese Patients with Hepatitis C Virus Infection

Ijichi, Toshiharu; Kono, Ichiyo; Mori, Shigeki; Nakajima, Kenji; Nakagawa, Masanori; Okanoue, Takeshi

doi:10.2169/internalmedicine.42.394

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…Persistent HCV infection has been suggested to be a mechanism of EGPA (18). Some EGPA patients have been reported to have HCV infection (18)(19)(20). While the antigen responsible for EGPA has not been identified, it is suggested that an allergic background and hypereosinophilia may be induced by the persistent activation of CD4 + T cells (21,22).…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Virus-associated Neuropathy Accompanied by Eosinophilic Vasculitis and Granuloma Formation

et al. 2014

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We herein report the case of a patient with hepatitis C virus (HCV)-associated neuropathy with atypical pathological findings of a biopsied sural nerve. A 48-year-old man was admitted for a gait disturbance. Purpura and edema on the legs and hyperalgesia on the distal extremities were noted. The plasma HCV viral load was high, and cryoglobulin was positive. In the biopsied sural nerve, perivascular eosinophilic infiltration was associated with extravascular granuloma formation in the epineurium. The patient's symptoms disappeared following treatment with interferon-α and ribavirin. The present case suggests that HCV infection can lead to peripheral neuropathy associated with eosinophilic infiltration and granuloma formation.

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Section: Discussionmentioning

confidence: 99%

Hepatitis C Virus-associated Neuropathy Accompanied by Eosinophilic Vasculitis and Granuloma Formation

et al. 2014

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“…26 Lastly, peripheral neuropathy has also been reported in HCV-infected patients who test persistently negative for mixed cryoglobulinemia. 18,23,[26][27][28][29][30][31] Neuropathy Syndromes HCV-associated neuropathy most frequently manifests as a distal sensory or sensorimotor polyneuropathy followed by mononeuropathy multiplex 21,26,[32][33][34][35] and rarely polyarteritis nodosa. 36 Other types of neuropathy include demyelinating polyneuropathy, 32,37,38 small fiber neuropathy with restless leg syndrome, 35 pure motor axonal neuropathy, 39 and cranial (eg, oculomotor and facial) neuropathy.…”

Section: Risk Factors For Neuropathymentioning

confidence: 99%

“…36 Other types of neuropathy include demyelinating polyneuropathy, 32,37,38 small fiber neuropathy with restless leg syndrome, 35 pure motor axonal neuropathy, 39 and cranial (eg, oculomotor and facial) neuropathy. 26,34 Generally, mononeuropathy and mononeuropathy multiplex seem to be more common in patients without cryoglobulinemia. 26,32,29 Pathology No significant qualitative difference was found in neuropathologic features in comparison between patients with and without cryoglobulinemia.…”

Section: Risk Factors For Neuropathymentioning

confidence: 99%

Neuromuscular Diseases Associated With Chronic Hepatitis C Virus Infection

Stübgen

2011

Journal of Clinical Neuromuscular Disease

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Hepatitis C virus (HCV) infection is a growing international health problem, and more than 170 million people are chronic carriers. Up to 50% of HCV-positive patients develop at least one extrahepatic manifestation during the course of disease. To varying degrees of certainty, there is evidence of an association between chronic HCV infection and a variety of neuromuscular diseases. The pathogenesis of most extrahepatic diseases remains unclear but possibly includes HCV lymphotropism and/or HCV-induced autoantibodies. The therapeutic approach to HCV-associated autoimmune disorders entails eradication of HCV with one of the recombinant interferon-alpha preparations with or without additional immunosuppressive drugs.

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“…Major clinical manifestation is hepatitis and some level of fibrosis, followed by nonspecific symptoms such as fatigue. In addition, hepatitis C virus infection (HCV) may impair quality of life even in the absence of severe disease [3][4][5] . The prevalence of HCV in Brazil is not exactly known; there are reports from several areas which suggest that mean prevalence is between 1% and 2% of general population 2 .…”

Section: Introductionmentioning

confidence: 99%

Neuropatia periférica associada à crioglobulinemia em paciente com hepatite C: relato de caso e revisão da literatura

2013

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BACKGROUND AND OBJECTIVES:Hepatitis C is an infectious disease affecting approximately 170 million people worldwide. In addition to the liver disease, the virus causes extra-liver manifestations, such as peripheral neuropathy and essential mixed cryoglobulinemia. This study aimed at presenting a case of a patient with hepatitis C virus who developed cryoglobulinemia associated to peripheral neuropathy. CASE REPORT: Male patient, 62 years old, with hepatitis C subtype 1 diagnosed more than 10 years ago, with possible contamination after right knee surgical procedure. He presented initially "shock"-type pain episodes followed by hands and feet continuous paresthesia in boot-glove pattern, associated to Raynaud phenomenon and lower limbs petechiae. He evolved along the years with motor deficit in left fibular nerve leading to foot-drop. Plasma cryoglobulines test was positive. Pain became continuous, severe, symmetric, located in the distal third and lateral face of lower limbs. When the evaluation of the multidisciplinary pain and rehabilitation team was asked, tramadol (50 mg) every 6 hours and gabapentin (900 mg/day) were prescribed in association to pulse therapy with total resolution of pain in some weeks. Orthosis and daily rehabilitation were needed for several months. CONCLUSION: As early as possible, multimodal treatment with different classes of drugs associated to adequate rehabilitation is directly associated to a better prognosis for this type of neuropathy.

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Peripheral Neuropathy in Japanese Patients with Hepatitis C Virus Infection

Cited by 12 publications

References 29 publications

Hepatitis C Virus-associated Neuropathy Accompanied by Eosinophilic Vasculitis and Granuloma Formation

Hepatitis C Virus-associated Neuropathy Accompanied by Eosinophilic Vasculitis and Granuloma Formation

Neuromuscular Diseases Associated With Chronic Hepatitis C Virus Infection

Neuropatia periférica associada à crioglobulinemia em paciente com hepatite C: relato de caso e revisão da literatura

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