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Journal of Neurology

, Volume 258, Issue 7, pp 1321–1326 | Cite as

Mononeuropathy multiplex associated with acute parvovirus B19 infection: characteristics, treatment and outcome

  • Timothée Lenglet
  • Julien Haroche
  • Aurélie Schnuriger
  • Thierry Maisonobe
  • Karine Viala
  • Yanne Michel
  • Farhat Chelbi
  • David Grabli
  • Paul Seror
  • Antoine Garbarg-Chenon
  • Zahir Amoura
  • Pierre Bouche
Original Communication

Abstract

To describe the characteristics of peripheral neuropathy related to acute parvovirus B19 (B19V) infection. We reviewed clinical, electrophysiological and histological data of three patients with peripheral neuropathy and positive B19V detection (IgG, IgM and PCR) compatible with acute infection. The neuropathy fulfilled criteria for mononeuropathy multiplex (MM). It could be preceded by or concurrent with a limited purpuric eruption, but systemic manifestations were absent. The first neurological symptoms were always sensory and localized in a hand. Neuropathy was initially limited to a restricted sensory part of a nerve trunk territory. The course was subacute with successive and asymmetric injury of the limb and cranial nerves. Electromyographic study confirmed the diagnosis of MM with multifocal asymmetric sensory and motor axonal loss in two patients, whereas the neuropathy was purely sensory and limited to two nerves in the other patient. Nerve biopsies showed no evidence of necrotizing vasculitis but, in one patient, revealed a lymphocytic perivascular infiltrate evocative of hypersensitivity vasculitis secondary to an infectious agent. Intravenous immunoglobulin (IVIg) was systematically administered. Long-term outcome was good but with incomplete sensory recovery and, for one patient, persistence of a functional disability. B19 V infection should be considered in the etiological assessment of MM, especially in the event of a progressive sensory disorder in the hands and a concomitant history of rash. IVIg may be an effective treatment for this inflammatory disorder.

Keywords

Vasculitis Mononeuropathy multiplex Parvovirus B19 Neurophysiology 

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Timothée Lenglet
    • 1
    • 2
  • Julien Haroche
    • 3
  • Aurélie Schnuriger
    • 4
  • Thierry Maisonobe
    • 2
  • Karine Viala
    • 2
  • Yanne Michel
    • 4
  • Farhat Chelbi
    • 3
  • David Grabli
    • 1
  • Paul Seror
    • 2
  • Antoine Garbarg-Chenon
    • 4
  • Zahir Amoura
    • 3
  • Pierre Bouche
    • 2
  1. 1.Département de Neurologie, Hôpital de la Pitié-SalpêtrièreAssistance Publique des Hôpitaux de Paris (APHP)Paris Cedex 13France
  2. 2.Département de Neurophysiologie Clinique, Hôpital de la Pitié-SalpêtrièreUniversité Paris VI, Assistance Publique des Hôpitaux de Paris (APHP)Paris Cedex 13France
  3. 3.Département de Médecine Interne, Hôpital de la Pitié-SalpêtrièreUniversité Paris VI, Assistance Publique des Hôpitaux de Paris (APHP)Paris Cedex 13France
  4. 4.Laboratoire de Virologie, Hôpital Armand TrousseauAssistance Publique des Hôpitaux de ParisParis Cedex 12France

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