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Confluent peripheral multiple mononeuropathy associated to acute hepatitis B: a case report
Marcello Caniello1, Patrícia Baxter, Angelina Maria Martins Lino
1School of Medicine, São Paulo University, SP, Brazil.
Revista Do Instituto De Medicina Tropical De Sao Paulo
|August 7, 2002
Summary
This study reports a rare case of acute hepatitis B presenting as severe peripheral neuropathy. The hepatitis B virus likely caused nerve damage through direct action or immune complex-induced vasculitis.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Hepatitis B virus (HBV) infection is a global health concern.
- Neurological complications associated with HBV are uncommon.
- This case highlights a rare neurological manifestation of acute hepatitis B.
Observation:
- A 33-year-old male presented with progressive sensory and motor deficits in all four limbs.
- Clinical presentation included pain, tingling, decreased sensation, and foot drop.
- Diagnostic tests confirmed acute hepatitis B infection with elevated ALT levels.
Findings:
- Electroneuromyography revealed severe axonal peripheral neuropathy with denervation.
- Nerve biopsy showed intense vasculitis affecting the vasa nervorum.
- The patient was diagnosed with multiple confluent mononeuropathy associated with acute hepatitis B.
Implications:
- This case suggests a potential link between acute hepatitis B and severe peripheral neuropathy.
- The underlying mechanism may involve direct viral neurotoxicity or immune-mediated vasculitis.
- Further research is warranted to understand this association and its pathogenesis.