Cryoglobulinemic peripheral neuropathy in hepatitis C virus infection: clinical and anatomical correlations of 22 cases
Cryoglobulinemic neuropathies caused by hepatitis C virus are frequent and may have severe clinical outcomes. The aim of this study was to clarify the clinical and anatomical correlations of these neuropathies. Between 1992 and 2007, 22 consecutive patients with cryoglobulinemic neuropathies caused...
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| Veröffentlicht in: | Revue neurologique 2010-05, Vol.166 (5), p.509-514 |
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| creator | Taieb, G Maisonobe, T Musset, L Cacoub, P Léger, J-M Bouche, P |
| description | Cryoglobulinemic neuropathies caused by hepatitis C virus are frequent and may have severe clinical outcomes. The aim of this study was to clarify the clinical and anatomical correlations of these neuropathies.
Between 1992 and 2007, 22 consecutive patients with cryoglobulinemic neuropathies caused by hepatitis C virus were retrospectively included. Patients were evaluated clinically, electrophysiologically and underwent a neuromuscular biopsy. The group of patients with vasculitis on nerve biopsy was compared with the group without vasculitis.
All the neuropathies were axonal with 11 polyneuropathies and 11 mononeuropathies multiplex. The seven patients with medium-sized vasculitis on the nerve biopsy presented an acute sensorimotor mononeuropathy multiplex in six cases (85%), with ischemic conduction block in three cases (42%) and wallerian degeneration in four cases (57%). Among the four patients with small-sized vasculitis, two had a mononeuropathy multiplex (50%) without conduction block (0%) and with wallerian degeneration in one case (25%). The 11 patients without vasculitis (nine lymphocytic perivascular infiltrates and two non inflammatory biopsies) had a polyneuropathy in eight cases (72%) without conduction block and wallerian degeneration (0%). The type of neuropathy was different in the group of patients with vasculitis compared with the group without vasculitis. The neuropathies with vasculitis were significantly different with more frequent mononeuropathies multiplex (p |
| doi_str_mv | 10.1016/j.neurol.2009.10.019 |
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Between 1992 and 2007, 22 consecutive patients with cryoglobulinemic neuropathies caused by hepatitis C virus were retrospectively included. Patients were evaluated clinically, electrophysiologically and underwent a neuromuscular biopsy. The group of patients with vasculitis on nerve biopsy was compared with the group without vasculitis.
All the neuropathies were axonal with 11 polyneuropathies and 11 mononeuropathies multiplex. The seven patients with medium-sized vasculitis on the nerve biopsy presented an acute sensorimotor mononeuropathy multiplex in six cases (85%), with ischemic conduction block in three cases (42%) and wallerian degeneration in four cases (57%). Among the four patients with small-sized vasculitis, two had a mononeuropathy multiplex (50%) without conduction block (0%) and with wallerian degeneration in one case (25%). The 11 patients without vasculitis (nine lymphocytic perivascular infiltrates and two non inflammatory biopsies) had a polyneuropathy in eight cases (72%) without conduction block and wallerian degeneration (0%). The type of neuropathy was different in the group of patients with vasculitis compared with the group without vasculitis. The neuropathies with vasculitis were significantly different with more frequent mononeuropathies multiplex (p<0.05), acute early stage (p<0.01), disability (p<0.05) and wallerian degeneration (p=0.01).
Among hepatitis C patients with cryoglobulinemia, neuropathies with small-sized vasculitis show a pattern between severe mononeuropathies multiplex with medium-sized vasculitis and moderate polyneuropathies with lymphocytic perivascular infiltrates. In cryoglobulinemic vasculitis with hepatitis C, the severity of the neuropathy depends on the nature of the cellular inflammation and the size of the vessel involvement.</description><identifier>ISSN: 0035-3787</identifier><identifier>DOI: 10.1016/j.neurol.2009.10.019</identifier><identifier>PMID: 20338607</identifier><language>fre</language><publisher>France</publisher><subject>Aged ; Biopsy ; Blotting, Western ; Cryoglobulinemia - etiology ; Cryoglobulinemia - pathology ; Electrodiagnosis ; Electromyography ; Electrophysiology ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis C - complications ; Hepatitis C - pathology ; Humans ; Immunohistochemistry ; Liver - pathology ; Male ; Middle Aged ; Paraffin Embedding ; Peripheral Nervous System Diseases - etiology ; Peripheral Nervous System Diseases - pathology ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Vasculitis - complications ; Vasculitis - pathology</subject><ispartof>Revue neurologique, 2010-05, Vol.166 (5), p.509-514</ispartof><rights>Copyright 2009 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20338607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Taieb, G</creatorcontrib><creatorcontrib>Maisonobe, T</creatorcontrib><creatorcontrib>Musset, L</creatorcontrib><creatorcontrib>Cacoub, P</creatorcontrib><creatorcontrib>Léger, J-M</creatorcontrib><creatorcontrib>Bouche, P</creatorcontrib><title>Cryoglobulinemic peripheral neuropathy in hepatitis C virus infection: clinical and anatomical correlations of 22 cases</title><title>Revue neurologique</title><addtitle>Rev Neurol (Paris)</addtitle><description>Cryoglobulinemic neuropathies caused by hepatitis C virus are frequent and may have severe clinical outcomes. The aim of this study was to clarify the clinical and anatomical correlations of these neuropathies.
Between 1992 and 2007, 22 consecutive patients with cryoglobulinemic neuropathies caused by hepatitis C virus were retrospectively included. Patients were evaluated clinically, electrophysiologically and underwent a neuromuscular biopsy. The group of patients with vasculitis on nerve biopsy was compared with the group without vasculitis.
All the neuropathies were axonal with 11 polyneuropathies and 11 mononeuropathies multiplex. The seven patients with medium-sized vasculitis on the nerve biopsy presented an acute sensorimotor mononeuropathy multiplex in six cases (85%), with ischemic conduction block in three cases (42%) and wallerian degeneration in four cases (57%). Among the four patients with small-sized vasculitis, two had a mononeuropathy multiplex (50%) without conduction block (0%) and with wallerian degeneration in one case (25%). The 11 patients without vasculitis (nine lymphocytic perivascular infiltrates and two non inflammatory biopsies) had a polyneuropathy in eight cases (72%) without conduction block and wallerian degeneration (0%). The type of neuropathy was different in the group of patients with vasculitis compared with the group without vasculitis. The neuropathies with vasculitis were significantly different with more frequent mononeuropathies multiplex (p<0.05), acute early stage (p<0.01), disability (p<0.05) and wallerian degeneration (p=0.01).
Among hepatitis C patients with cryoglobulinemia, neuropathies with small-sized vasculitis show a pattern between severe mononeuropathies multiplex with medium-sized vasculitis and moderate polyneuropathies with lymphocytic perivascular infiltrates. In cryoglobulinemic vasculitis with hepatitis C, the severity of the neuropathy depends on the nature of the cellular inflammation and the size of the vessel involvement.</description><subject>Aged</subject><subject>Biopsy</subject><subject>Blotting, Western</subject><subject>Cryoglobulinemia - etiology</subject><subject>Cryoglobulinemia - pathology</subject><subject>Electrodiagnosis</subject><subject>Electromyography</subject><subject>Electrophysiology</subject><subject>Enzyme-Linked Immunosorbent Assay</subject><subject>Female</subject><subject>Hepatitis C - complications</subject><subject>Hepatitis C - pathology</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Liver - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Paraffin Embedding</subject><subject>Peripheral Nervous System Diseases - etiology</subject><subject>Peripheral Nervous System Diseases - pathology</subject><subject>Retrospective Studies</subject><subject>Reverse Transcriptase Polymerase Chain Reaction</subject><subject>Vasculitis - complications</subject><subject>Vasculitis - pathology</subject><issn>0035-3787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kEtPwzAQhH0A0fL4Bwj5xinBj8ROuKGIl1SJC5yjrbOhrpI42Amo_x63lMNqd0bfzGEJueYs5Yyru2064OxdlwrGymiljJcnZMmYzBOpC70g5yFsGRNcM3lGFoJJWSiml-Sn8jv32bn13NkBe2voiN6OG_TQ0UPpCNNmR-1ANxhPO9lAK_pt_Ryi2aKZrBvuqYlxa2IGhiYOTK4_SOO8xw72UKCupUJQAwHDJTltoQt4ddwX5OPp8b16SVZvz6_VwyoZecamRJYNQKYN53qteGkQQCitZaaFRIWqNNDwPGvaTBXctEVhDGgu8j2ds8LIC3L71zt69zVjmOreBoNdBwO6OdRaShWzsozkzZGc1z029ehtD35X__9K_gJ3KG2k</recordid><startdate>201005</startdate><enddate>201005</enddate><creator>Taieb, G</creator><creator>Maisonobe, T</creator><creator>Musset, L</creator><creator>Cacoub, P</creator><creator>Léger, J-M</creator><creator>Bouche, P</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201005</creationdate><title>Cryoglobulinemic peripheral neuropathy in hepatitis C virus infection: clinical and anatomical correlations of 22 cases</title><author>Taieb, G ; Maisonobe, T ; Musset, L ; Cacoub, P ; Léger, J-M ; Bouche, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p140t-39daa47c117b619ceaa267734723e6e69cad154df4681cf88cca71257b61508c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>fre</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Biopsy</topic><topic>Blotting, Western</topic><topic>Cryoglobulinemia - etiology</topic><topic>Cryoglobulinemia - pathology</topic><topic>Electrodiagnosis</topic><topic>Electromyography</topic><topic>Electrophysiology</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>Female</topic><topic>Hepatitis C - complications</topic><topic>Hepatitis C - pathology</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Liver - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Paraffin Embedding</topic><topic>Peripheral Nervous System Diseases - etiology</topic><topic>Peripheral Nervous System Diseases - pathology</topic><topic>Retrospective Studies</topic><topic>Reverse Transcriptase Polymerase Chain Reaction</topic><topic>Vasculitis - complications</topic><topic>Vasculitis - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Taieb, G</creatorcontrib><creatorcontrib>Maisonobe, T</creatorcontrib><creatorcontrib>Musset, L</creatorcontrib><creatorcontrib>Cacoub, P</creatorcontrib><creatorcontrib>Léger, J-M</creatorcontrib><creatorcontrib>Bouche, P</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Revue neurologique</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Taieb, G</au><au>Maisonobe, T</au><au>Musset, L</au><au>Cacoub, P</au><au>Léger, J-M</au><au>Bouche, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cryoglobulinemic peripheral neuropathy in hepatitis C virus infection: clinical and anatomical correlations of 22 cases</atitle><jtitle>Revue neurologique</jtitle><addtitle>Rev Neurol (Paris)</addtitle><date>2010-05</date><risdate>2010</risdate><volume>166</volume><issue>5</issue><spage>509</spage><epage>514</epage><pages>509-514</pages><issn>0035-3787</issn><abstract>Cryoglobulinemic neuropathies caused by hepatitis C virus are frequent and may have severe clinical outcomes. The aim of this study was to clarify the clinical and anatomical correlations of these neuropathies.
Between 1992 and 2007, 22 consecutive patients with cryoglobulinemic neuropathies caused by hepatitis C virus were retrospectively included. Patients were evaluated clinically, electrophysiologically and underwent a neuromuscular biopsy. The group of patients with vasculitis on nerve biopsy was compared with the group without vasculitis.
All the neuropathies were axonal with 11 polyneuropathies and 11 mononeuropathies multiplex. The seven patients with medium-sized vasculitis on the nerve biopsy presented an acute sensorimotor mononeuropathy multiplex in six cases (85%), with ischemic conduction block in three cases (42%) and wallerian degeneration in four cases (57%). Among the four patients with small-sized vasculitis, two had a mononeuropathy multiplex (50%) without conduction block (0%) and with wallerian degeneration in one case (25%). The 11 patients without vasculitis (nine lymphocytic perivascular infiltrates and two non inflammatory biopsies) had a polyneuropathy in eight cases (72%) without conduction block and wallerian degeneration (0%). The type of neuropathy was different in the group of patients with vasculitis compared with the group without vasculitis. The neuropathies with vasculitis were significantly different with more frequent mononeuropathies multiplex (p<0.05), acute early stage (p<0.01), disability (p<0.05) and wallerian degeneration (p=0.01).
Among hepatitis C patients with cryoglobulinemia, neuropathies with small-sized vasculitis show a pattern between severe mononeuropathies multiplex with medium-sized vasculitis and moderate polyneuropathies with lymphocytic perivascular infiltrates. In cryoglobulinemic vasculitis with hepatitis C, the severity of the neuropathy depends on the nature of the cellular inflammation and the size of the vessel involvement.</abstract><cop>France</cop><pmid>20338607</pmid><doi>10.1016/j.neurol.2009.10.019</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Biopsy Blotting, Western Cryoglobulinemia - etiology Cryoglobulinemia - pathology Electrodiagnosis Electromyography Electrophysiology Enzyme-Linked Immunosorbent Assay Female Hepatitis C - complications Hepatitis C - pathology Humans Immunohistochemistry Liver - pathology Male Middle Aged Paraffin Embedding Peripheral Nervous System Diseases - etiology Peripheral Nervous System Diseases - pathology Retrospective Studies Reverse Transcriptase Polymerase Chain Reaction Vasculitis - complications Vasculitis - pathology |
| title | Cryoglobulinemic peripheral neuropathy in hepatitis C virus infection: clinical and anatomical correlations of 22 cases |
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