丙型肝炎相关冷球蛋白血症性神经病变：奥卡西平在疼痛控制中的潜在作用。
Hepatitis C-related cryoglobulinemic neuropathy: potential role of oxcarbazepine for pain control.
作者信息
Moretti Rita, Caruso Paola, Dal Ben Matteo, Gazzin Silvia, Tiribelli Claudio
机构信息
Neurology Clinic, Department of Medical, Surgical, and Health Sciences, University of Trieste, 34100, Trieste, Italy.
Italian Liver Foundation, Centro Studi Fegato, AREA Science Park, Bldg. Q, Ss 14, km 163.5, 34149, Trieste, Italy.
出版信息
BMC Gastroenterol. 2018 Jan 25;18(1):19. doi: 10.1186/s12876-018-0751-9.
BACKGROUND
Peripheral neuropathy is one most common, limiting and invalidating neurological symptom in subjects with hepatitis C virus and mixed cryoglobulinemia. Notably, the medical therapy proposed to eradicate HCV, can frequently exacerbate the painful neuropathy. Therefore, neuropathy therapies are insufficient and inadequate, and comprise immunosuppressive drugs, such as steroid or cyclosporine, intravenous immunoglobulin or plasma exchange. These have shown variable success in case reports, with a presumably temporary effect, but with major side effects.
METHODS
We assessed the effects of oxcarbazepine treatment in 67 cases of cryoglobulinemia related neuropathy, who did not respond to either steroid or Gabapentin, or Pregabalin. Oxcarbazepine was chosen based on the promising preliminary results.
RESULTS
Patients treated with Oxcarbazepine showed a rapid, discrete and persistent relief of polyneuropathic signs, without consistent side effects, and with a limited interaction with concomitant drugs.
CONCLUSIONS
These data favor the use of oxcarbazepine as a useful tool in the management of neuropathic pain associated with Hepatitis-C cryoglobulin neuropathy.
背景
周围神经病变是丙型肝炎病毒感染和混合性冷球蛋白血症患者中最常见、限制活动且使身体衰弱的神经症状。值得注意的是，用于根除丙肝病毒的药物治疗常常会加重疼痛性神经病变。因此，针对神经病变的治疗并不充分且不完善，包括使用免疫抑制药物，如类固醇或环孢素、静脉注射免疫球蛋白或血浆置换。这些治疗方法在病例报告中显示出不同程度的成功，但可能只是暂时有效，且有严重的副作用。
方法
我们评估了奥卡西平对67例与冷球蛋白血症相关的神经病变患者的治疗效果，这些患者对类固醇、加巴喷丁或普瑞巴林均无反应。基于初步的良好结果，我们选择了奥卡西平进行治疗。
结果
接受奥卡西平治疗的患者多发性神经病变体征迅速、明显且持续缓解，无持续副作用，与同时服用的药物相互作用有限。
结论
这些数据支持将奥卡西平作为治疗丙型肝炎冷球蛋白神经病变相关神经病理性疼痛的有效药物。
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