Peripheral neuropathy in hepatitis C virus-related mixed cryoglobulinaemia: existing treatments and a positive symptomatic response to oxcarbazepine.
Peripheral neuropathy is the most common symptom in patients with hepatitis C virus (HCV) associated mixed cryoglobulinaemia, in whom it may be the first clinical manifestation. Very frequently, the medical therapy proposed to treat HCV and cryoglobulinaemia causes an exacerbation of the disabling neuropathy. Therefore, other neuropathy treatments have been proposed, such as alternative immunosuppressive agents (steroids or cyclosporine) and plasma exchange, which, according to case reports, have yielded inconsistent results and presumably exert only temporary effects as they do not promote clearance of HCV. We present five cases of cryoglobulinaemia-related neuropathy resistant to steroids and gabapentin. Oxcarbazepine was introduced and produced moderate and persistent relief of symptoms without side effects.
Moretti
Rita
R
Clinical Neurology, Department of Internal Medicine and Clinical Neurology, University of Trieste, Trieste, Italy. moretti@univ.trieste.it
Torre
Paola
P
Antonello
Rodolfo M
RM
Cattaruzza
Tatiana
T
Pizzolato
Gilberto
G
D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D002220:Carbamazepine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002908:Chronic Disease; D003449:Cryoglobulinemia / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D004351:Drug Resistance; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D000078330:Oxcarbazepine; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000927:Anticonvulsants; D002220:Carbamazepine; D000078330:Oxcarbazepine