The presentation of viral hepatitis C infection without cryoglobulinemia with a peripheral neuropathy. Five cases reports

Peripheral neuropathies are the most common neurological complication of viral hepatitis C (VHC). This paper reports 5 patients (3 men & 2 women; mean age 56 years) with peripheral neuropathy as the presentation of viral hepatitis C infection without cryoglobulinemia. Paraesthesiae were the most frequent symptom. EMG demonstrated that one patient had a polyneuropathy and 4 had mononeuritis multiplex. The complement level was normal in all patients but the rheumatoid factor positive in 2. Aetiological investigations were negative. Treatment outcome was variable.

Neurological disorders in VHC infection in the absence of cryoglobulinemia has been reported recently suggesting that other mechanisms can be responsible, such as a direct action of the virus on the nervous system. There is no consensus on the optimal treatment and the prognosis is variable.

VHC infection may present as a peripheral neuropathy, hence the need for VHC serology in the aetiological investigations of this syndrome.

27 references.