[Peripheral neuropathies and chronic hepatitis C: a frequent association?].
OBJECTIVE
The aim of this prospective study was to evaluate the prevalence of the peripheral neuropathies associated with chronic hepatitis C and their clinical, electrophysiological and histological characteristics.


METHODS
Thirty six patients admitted from December 1994 to January 1996 for chronic hepatitis C were prospectively investigated. Laboratory data included liver blood tests, serum cryoprecipitate immunoelectrophoresis, assays for anti-nuclear antibody, rheumatoid factor, circulating immune complexes, anti-SSA and anti-SSB antibodies. For each patient, a clinical neurological evaluation as well as an electrophysiological evaluation were performed by the same operator. In presence of peripheral neuropathy, a neuromuscular biopsy was performed.


RESULTS
In seven patients (19%), a peripheral neuropathy was diagnosed related to hepatitis C virus in 3 patients. In these 3 patients presenting with leg paresthesia, an axonal sensitive neuropathy was evidenced by electromyography. A neuromuscular biopsy performed in two of these patients showed a severe diminution of the myelinated fibers associated with vasculitis lesions in one patient. A skin biopsy was performed in the third patient with leg purpura revealing a leukocytoclasic vasculitis. A positive cryoglobulinemia was found in two of these patients.


CONCLUSIONS
In chronic hepatitis C, the prevalence of peripheral neuropathy is 8% and usually associated with cryoglobulinemia. It is an axonal neuropathy with diminution of the myelinated fibers and vasculitis lesions in the absence of cryoglobulinemia.
Ripault
M P
MP
Service d'Hépato-Gastroentérologie et d'Assistance Nutritive, Hôpital Dupuytren, Limoges.
Borderie
C
C
Dumas
P
P
Vallat
J M
JM
Goujon
J M
JM
Brecheteau
P
P
Beauchant
M
M
Silvain
C
C
D000328:Adult; D000368:Aged; D001706:Biopsy; D003449:Cryoglobulinemia / Q000097:blood / Q000821:virology; D004576:Electromyography; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000821:virology*; D015995:Prevalence; D011446:Prospective Studies