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Vasculitic multiplex mononeuritis: polyarteritis nodosa versus cryoglobulinemic vasculitis
Corinna Steidl1, Martin W Baumgaertel, Eva Neuen-Jacob
1Alfried-Krupp-Krankenhaus, Essen, Germany. costeidl@gmx.de
Hepatitis C infection can cause cryoglobulinemic vasculitis, leading to nerve damage and skin purpura. This case highlights the importance of screening for chronic hepatitis C in patients with vasculitis symptoms.
Area of Science:
- Neurology
- Immunology
- Hepatology
Background:
- Multiplex mononeuritis (MM) is a rare neurological disorder.
- Polyarteritis nodosa (PAN) is a systemic vasculitis that can affect nerves.
- Chronic hepatitis C infection is associated with various autoimmune phenomena.
Observation:
- A 76-year-old female presented with progressive motor-sensory multiplex mononeuritis.
- Muscle and nerve biopsy confirmed polyarteritis nodosa (PAN).
- Corticosteroid treatment failed, and symptoms like paresthesias and leg purpura worsened.
Findings:
- Hepatitis screening identified chronic hepatitis C infection.
- The patient had cryoglobulinemia Type II (IgM-kappa Ig A).
- Diagnosis of hepatitis C-associated cryoglobulinemic vasculitis was established.
Implications:
- This case underscores the link between chronic hepatitis C, cryoglobulinemia, and vasculitis.
- Early diagnosis and treatment of underlying hepatitis C are crucial for managing this condition.
- Highlights the need for comprehensive screening in patients with unexplained vasculitis.
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