[The presentation of viral hepatitis C infection without cryoglobulinemia with a peripheral neuropathy. Five case reports].
BACKGROUND
Peripheral neuropathies are the most common neurological complication of viral hepatitis C infection with mixed cryoglobulinemia.


METHODS
We report five cases (three men, two women) of peripheral neuropathies revealing viral hepatitis C infection without cryoglobulinemia; the patients' mean age was 56 years. Paresthesias were the most frequent symptom. Electroneuromyographic examination found one case of polyneuropathy and four cases of multiplex mononeuropathies; the complement level was normal in all patients and the rheumatoid factor positive in two cases. Etiological investigations for peripheral neuropathy remained negative. Treatment and outcome were variable.


CONCLUSIONS
Negative cryoglobulinemia in cases of VHC infection with neurological features has been described in the last few years, suggesting the possibility of other mechanisms such as direct action of the virus on the nervous system. There is no consensus on the treatment and outcome is variable.


CONCLUSIONS
Peripheral neuropathy may reveal VHC infection, underscoring the need for VHC serology testing in etiological investigations for peripheral neuropathies.
Rafai
M A
MA
Service de Neurologie - Explorations fonctionnelles, CHU ibn Rochd, quartier des hôpitaux, Casablanca, Maroc. mo.mi2@caramail.com
Gam
I
I
Fadel
H
H
Hakim
K
K
El Moutawakkil
B
B
Bendahmane
A
A
Kissani
N
N
Alaoui
R
R
Cherkaoui
A
A
Slassi
I
I
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003449:Cryoglobulinemia / Q000175:diagnosis*; D004576:Electromyography; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D020422:Mononeuropathies / Q000175:diagnosis* / Q000188:drug therapy; D009460:Neurologic Examination; D011115:Polyneuropathies / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D016898:Interferon-alpha