Momoh Rabiu, Lawton Benjamin, Gaznavee Zibran, Kulkarni Amey, Chiang Lynden, Dahabreh John P, Malkania Bipin, Chawla Vipal
Critical Care, Medway Maritime Hospital, Gillingham, GBR.
Critical Care Medicine, Medway NHS Foundation Trust, Gillingham, GBR.
Cureus. 2025 Jan 3;17(1):e76841. doi: 10.7759/cureus.76841. eCollection 2025 Jan.
This case report aims to shed more light on the increasingly described scenario of extrahepatic central nervous system (CNS) manifestations of hepatitis C virus (HCV) infection. We present a possible rare case of acute disseminated encephalomyelitis manifesting as ring-enhancing lesions on magnetic resonance imaging (MRI) of the head study conducted on a gentleman in his 50s who presented to the hospital with neurologic features, with an evident demonstration of HCV ribonucleic acid (RNA) in the patient's cerebrospinal fluid sampled. A closer differential of tumefactive multiple sclerosis due to HCV was considered as well. An increasing association of HCV infection with non-Hodgkin's (B-cell) lymphoma, which can potentially affect the brain, is also being noted in the literature. Other common causes of ring-enhancing brain lesions were considered, and attempts were made to exclude a majority of them in this case report.
本病例报告旨在更深入地探讨丙型肝炎病毒（HCV）感染的肝外中枢神经系统（CNS）表现这一越来越多地被描述的情况。我们报告了一例可能罕见的急性播散性脑脊髓炎病例，该病例表现为对一名50多岁男性进行头部磁共振成像（MRI）检查时出现环形强化病变，该患者因神经系统症状入院，在采集的患者脑脊液中明显检测到HCV核糖核酸（RNA）。还考虑了与HCV相关的肿胀性多发性硬化的鉴别诊断。文献中也注意到HCV感染与非霍奇金（B细胞）淋巴瘤之间的关联日益增加，后者可能会影响大脑。本病例报告考虑了脑内环形强化病变的其他常见原因，并试图排除其中的大多数原因。
