David W S, Peine C, Schlesinger P, Smith S A
Department of Neurology, Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA.
Muscle Nerve. 1996 Dec;19(12):1596-602. doi: 10.1002/(SICI)1097-4598(199612)19:12<1596::AID-MUS9>3.0.CO;2-5.
A 39-year-old man developed sequential acute mononeuropathies involving both median, both ulnar, and the right radial and left peroneal nerves. Electrophysiology demonstrated an asymmetric sensorimotor axonal polyneuropathy; nerve biopsy confirmed a vasculitis. Laboratory evaluation revealed a mixed cryoglobulinemia and active hepatitis C infection. The patient stabilized with prednisone/cyclophosphamide/interferon-alpha. Hepatitis C should be considered in the differential diagnosis of mononeuropathy multiplex. Accurate diagnosis is important, as interferon-alpha may prevent transition to chronic hepatitis/cirrhosis.
一名39岁男性先后出现累及双侧正中神经、双侧尺神经、右侧桡神经和左侧腓总神经的急性单神经病。电生理检查显示为不对称性感觉运动轴索性多发性神经病；神经活检证实为血管炎。实验室检查发现混合性冷球蛋白血症和活动性丙型肝炎感染。患者使用泼尼松/环磷酰胺/α干扰素后病情稳定。在多发性单神经病的鉴别诊断中应考虑丙型肝炎。准确诊断很重要，因为α干扰素可能预防病情转变为慢性肝炎/肝硬化。
