[Peripheral neuropathy and hepatitis C virus infection: more than cryoglobulinemia].
OBJECTIVE
To study characteristics of peripheral neuropathies associated with hepatitis C virus infection.


METHODS
A study of two groups of four patients with peripheral neuropathy and infected with hepatitis C virus, and a literature review.


RESULTS
We observed four cases of peripheral neuropathy in patients with hepatitis C virus infection with persistent negativity of mixed cryoglobulinemia, and with no purpura, rheumatoid factor, or low C4 level. Neuropathy improved with treatment in three patients between 8 and 28 months after treatment was begun. We report four other observations of peripheral neuropathy with mixed cryoglobulinemia. Worsening of peripheral neuropathy was observed 2 to 13 weeks after initiation of interferon alpha despite improvement of hepatic parameters. After stopping interferon, peripheral neuropathy worsened (one case), stabilized (one case), or improved (two cases).


CONCLUSIONS
In patients infected with hepatitis C virus, peripheral neuropathy can be due to mixed cryoglobulinemia, periarteritis nodosa, and perhaps hepatitis C virus itself as suggested by our first observations. Low doses of interferon alpha may worsen peripheral neuropathy in patients with mixed cryoglobulinemia, as suggested in our later observations.
Lidove
O
O
Service de médecine interne, hôpital Foch, 40, rue Worth, 92151 Suresnes, France.
Maisonobe
T
T
Servan
J
J
Thibault
V
V
Léger
J M
JM
Piette
J C
JC
Cacoub
P
P
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D003449:Cryoglobulinemia / Q000150:complications* / Q000209:etiology; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000821:virology*
D000998:Antiviral Agents; D016898:Interferon-alpha