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Sensory neuropathy in patients with cryoglobulin negative hepatitis-C infection

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Abstract

There is growing evidence that hepatitis-C virus (HCV) infection might cause peripheral neuropathy. We aimed to investigate the prevalence, clinical and electrophysiological features of sensory neuropathy in patients with cryoglobulin negative HCV infection. We studied 46 consecutive cryoglobulin negative HCV positive patients (24 of them with and 22 without neuropathic symptoms, NS) and compared to 28 age and gender matched controls. In all patients and controls, clinical neuropathy symptom (NSS) and neuropathy deficit scores (NDS) were assessed and standard nerve conduction velocity (SNCV) and pain related-evoked potentials (PREP) were recorded. Both, SNCV and PREP were abnormal in 13 NS positive patients (13/46, 28%). Abnormal PREP but normal SNCV were found in 5 (5/46, 11%) NS positive and in 2 NS negative patients (2/46, 4%). PREP abnormalities correlated positive with both clinical neuropathy scores (NSS r = 0.62; p < 0.001; NDS r = 0.57; p < 0.001), but not with the duration of the disease, current viral load, or the virus subtype. PREP abnormalities were more frequent (16/33, 48.5%) in HCV patients treated with interferon than in therapy naïve patients (4/13, 30.8%); the difference was, however, not significant. In our present study (1) all virus subtypes are capable of inducing neuropathy, (2) no differences were found between interferon therapy and treatment naive patients, (3) the prevalence of peripheral sensory neuropathy including small sensory fibers (20/46, 43.5%) is higher than previously reported and (4) we found that detection of HCV associated neuropathy depends on the evaluation method.

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Abbreviations

CNAS:

Clinical neuropathy assessment score

HCV:

Hepatitis-C virus

LEP:

Laser evoked potentials

NDS:

Neuropathy deficit score

NSS:

Neuropathy symptom score

NS:

Neuropathy symptoms

PREP:

Pain related evoked potentials

SFN:

Small-fiber neuropathy

SNCV:

Standard nerve conduction velocity

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Conflict of interest

Dr. Katsarava has received research grants and honoraria from Allergan and Bayer, and is an advisory board member for Allergan. Headache research at the Department of Neurology in Essen is supported by the German Research Council (DFG), the German Ministry of Education and Research (BMBF), and the European Union. Prof. Diener received honoraria for participation in clinical trials, contribution to advisory boards, or oral presentations from Addex Pharma, Allergan, Almirall, AstraZeneca, Bayer Vital, Berlin Chemie, CoLucid, Bohringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Grunenthal, Janssen-Cilag, Lilly, La Roche, 3M Medica, Minster, MSD, Novartis, Johnson & Johnson, Pierre Fabre, Pfizer, Schaper and Brummer, Sanofi-Aventis, Weber & Weber. He also received financial support for research projects from Allergan, Almirall, AstraZeneca, Bayer, GlaxoSmithKline, Janssen-Cilag, and Pfizer. Dr. Yoon, Dr. Obermann, Ms. Dockweiler, Dr. Assert, Dr. Canbay, Dr. Haag, Dr. Gerken report no disclosures.

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Authors and Affiliations

  1. Department of Neurology, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany

    Min-Suk Yoon, Mark Obermann, Christina Dockweiler, Hans-Christoph Diener & Zaza Katsarava

  2. Laboratory Medicine, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany

    Roland Assert

  3. Department of Gastroenterology and Hepatology, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany

    Ali Canbay, Sebastian Haag & Guido Gerken

  4. Department of Neurology, Ruhr University Bochum, Gudrundstrasse 56, 44781, Bochum, Germany

    Min-Suk Yoon

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  1. Min-Suk Yoon
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  2. Mark Obermann
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Correspondence to Min-Suk Yoon.

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Yoon, MS., Obermann, M., Dockweiler, C. et al. Sensory neuropathy in patients with cryoglobulin negative hepatitis-C infection. J Neurol 258, 80–88 (2011). https://doi.org/10.1007/s00415-010-5686-1

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  • DOI: https://doi.org/10.1007/s00415-010-5686-1

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