Hepatitis Associated Vasculitic Multiple Mononeuropathy

History and clinical findings:
A 56-year-old woman with hepatitis C had symptoms of a polyneuropathy with asymmetrical distal pareses and painful sensory disturbances in the limbs.

Investigation:
In addition to positive serology for hepatitis C cryoglobulins were demonstrated and complement C4 was reduced. Biopsy of the sural nerve showed a vasculitic neuropathy.

Treatment and course:
The multiple neuropathy (cryoglobulinaemic neuropathy), associated with hepatitis C, was treated with corticosteroids (starting with 60 mg/d prednisolone) and the neurological abnormalities regressed well.

Conclusion:
Vasculitis associated with hepatitis C should be included in the differential diagnosis of peripheral neuropathy.

Author: HECKMANN JG, UNIV ERLANGEN NURNBERG, NEUROL KLIN, SHWABACHANLAGE 6 D-91054 ERLANGEN, GERMANY Source: DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT 1997 FEB28;122(9):259-262

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