Isolated central nervous system vasculitis associated with hepatitis C infection

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Hepatitis C virus (HCV) infection is increasingly associated with extrahepatic manifestations.
• Central nervous system (CNS) vasculitis is a rare condition often with idiopathic origins.
• This study investigates the link between HCV and CNS vasculitis.

Observation:

• Two patients with HCV infection presented with neurological deficits suggestive of CNS vasculitis.
• Case 1: A 43-year-old male with headache and hemiparesis, showing cerebral hemorrhage and granulomatous angiitis on biopsy.
• Case 2: A 39-year-old male with hemiparesis, dysarthria, and dysphagia, exhibiting infarcts and narrowing of cerebral arteries.

Findings:

• Both patients tested positive for hepatitis C antibodies.
• Cerebral angiography revealed characteristic findings of vasculitis in both cases.
• Treatment with corticosteroids, cyclophosphamide, and warfarin resulted in significant neurological improvement.

Implications:

• Hepatitis C should be considered in the differential diagnosis of unexplained CNS vasculitis.
• Prompt diagnosis and multimodal treatment can improve outcomes for patients with HCV-associated CNS vasculitis.
• Further research is warranted to elucidate the pathogenesis of HCV-induced vasculitis.