title: Nonsystemic vasculitic mononeuropathy multiplex, cryoglobulinemia, and hepatitis C.
abstract: 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.
authors.affiliation: Department of Neurology, Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA.
authors.forename: W S
authors.initials: WS
authors.lastname: David
authors.forename: C
authors.initials: C
authors.lastname: Peine
authors.forename: P
authors.initials: P
authors.lastname: Schlesinger
authors.forename: S A
authors.initials: SA
authors.lastname: Smith
mesh_terms: 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*