Related Experiment Videos
[Peripheral neuropathy and hepatitis C virus infection: more than cryoglobulinemia]
O Lidove1, T Maisonobe, J Servan
1Service de médecine interne, hôpital Foch, 40, rue Worth, 92151 Suresnes, France.
Purpose:
To study characteristics of peripheral neuropathies associated with hepatitis C virus infection.
Methods:
A study of two groups of four patients with peripheral neuropathy and infected with hepatitis C virus, and a literature review.
Results:
We observed four cases of peripheral neuropathy in patients with hepatitis C virus infection with persistent negativity of mixed cryoglobulinemia, and with no purpura, rheumatoid factor, or low C4 level. Neuropathy improved with treatment in three patients between 8 and 28 months after treatment was begun. We report four other observations of peripheral neuropathy with mixed cryoglobulinemia. Worsening of peripheral neuropathy was observed 2 to 13 weeks after initiation of interferon alpha despite improvement of hepatic parameters. After stopping interferon, peripheral neuropathy worsened (one case), stabilized (one case), or improved (two cases).
Discussion:
In patients infected with hepatitis C virus, peripheral neuropathy can be due to mixed cryoglobulinemia, periarteritis nodosa, and perhaps hepatitis C virus itself as suggested by our first observations. Low doses of interferon alpha may worsen peripheral neuropathy in patients with mixed cryoglobulinemia, as suggested in our later observations.