Nonsystemic vasculitic mononeuropathy multiplex, cryoglobulinemia, and hepatitis C.
A 39-year-old man developed sequential acute mononeuropathies involving both median, both ulnar, and the right radial and left peroneal nerves. Electrophysiology demonstrated an asymmetric sensorimotor axonal polyneuropathy; nerve biopsy confirmed a vasculitis. Laboratory evaluation revealed a mixed cryoglobulinemia and active hepatitis C infection. The patient stabilized with prednisone/cyclophosphamide/interferon-alpha. Hepatitis C should be considered in the differential diagnosis of mononeuropathy multiplex. Accurate diagnosis is important, as interferon-alpha may prevent transition to chronic hepatitis/cirrhosis.
David
W S
WS
Department of Neurology, Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA.
Peine
C
C
Schlesinger
P
P
Smith
S A
SA
D000328:Adult; D003449:Cryoglobulinemia / Q000150:complications*; D004594:Electrophysiology; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D013497:Sural Nerve / Q000378:metabolism / Q000473:pathology; D014657:Vasculitis / Q000150:complications*