Severe hepatitis C virus‐related cryoglobulinaemic sensory–motor polyneuropathy treated with pegylated interferon‐a2b and ribavirin: clinical, laboratory and neurophysiological study

Background/Aims: Severe involvement of central and/or peripheral nervous system is a rare complication of hepatitis C virus (HCV)‐related cryoglobulinaemia. Method: Four patients with HCV‐related type II/III cryoglobulinaemia (three males with genotype 1, one female with genotype 3) who presented with severe sensory–motor polyneuropathy, one with central nervous system involvement as well, were treated with pegylated IFNa‐2b 1.5 μg/kg/week and ribavirin 10.6 mg/kg/daily for 48 weeks. Neurological evaluation involved detailed clinical motor and sensory scores/scales and neurophysiological studies before and after treatment. Results/Conclusion: Three out of four patients had undetectable serum HCV‐RNA, normal levels of aminotransferases and substantially lower or undetectable levels of cryoglobulins at the end of treatment and at 24 weeks follow‐up period. Treatment was well tolerated and all patients exhibited significant improvement of neuropathy based on solid clinical and laboratory criteria that was associated with the virological response.