Peripheral neuropathy in hepatitis-related mixed cryoglobulinemia: electrophysiologic follow-up study.
A retrospective study was performed on 27 patients with hepatitis C (HCV)-related mixed cryoglobulinemia (purpura, arthralgia, hepatitis, glomerulonephritis, peripheral neuropathy) to assess peripheral nerve involvement during follow-up of up to 8 years. All patients had the same degree of organ/system involvement initially and were clinically evaluated at least annually. All 27 patients received steroids; 15 also received recombinant interferon-alpha 2b (rIFN-alpha 2b). At first examination, neurological signs and electrodiagnostic findings consistent with peripheral neuropathy were found in 20 (74%) and in 24 (88.8%) patients, respectively. Neurological evaluation and electrodiagnostic data at 3 and 8 years revealed worsening of neuropathy, whereas the other manifestations of mixed cryoglobulinemia (MC) were stable. At the last examination, clinical and electrodiagnostic signs of neuropathy were found in 25 patients (92.5%), occurring in 1 of 3 patients with normal initial findings, and worsened in 8. A more severe neuropathy was observed in 3 (25%) of the patients treated with prednisone alone and in 6 (40%) of the patients additionally treated with rIFN-alpha 2b. Our data confirm that in patients with HCV-related MC, peripheral nerve involvement is frequent, is progressive, and does not seem to benefit by addition of rIFN-alpha 2b to steroid treatment.
Ammendola
Angelo
A
Department of Neurological Sciences, Second University of Naples, Naples 80138, Italy.
Sampaolo
Simone
S
Ambrosone
Lucia
L
Ammendola
Eduardo
E
Ciccone
Gianluca
G
Migliaresi
Sergio
S
Di Iorio
Giuseppe
G
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003181:Complement C4 / Q000032:analysis; D003430:Cross-Sectional Studies; D003449:Cryoglobulinemia / Q000821:virology*; D004359:Drug Therapy, Combination; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000097:blood* / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009443:Neuritis / Q000503:physiopathology / Q000821:virology; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology / Q000821:virology*; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012217:Rheumatoid Factor / Q000097:blood; D013256:Steroids / Q000627:therapeutic use
D000998:Antiviral Agents; D003181:Complement C4; D007075:Immunoglobulin M; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D013256:Steroids; D012217:Rheumatoid Factor