丙型肝炎相关的血管炎性多发性单神经炎
[Hepatitis C-associated vasculitic mononeuritis multiplex].
作者信息
Heckmann J G, Engelhardt A, Druschky A, Blum H E, Neundörfer B
机构信息
Neurologische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg.
出版信息
Dtsch Med Wochenschr. 1997 Feb 28;122(9):259-62. doi: 10.1055/s-2007-1024211.
HISTORY AND CLINICAL FINDINGS
A 56-year-old woman with hepatitis C had symptoms of a polyneuropathy with asymmetrical distal pareses and painful sensory disturbances in the limbs.
INVESTIGATION
In addition to positive serology for hepatitis C cryoglobulins were demonstrated and complement C4 was reduced. Biopsy of the sural nerve showed a vasculitic neuropathy.
TREATMENT AND COURSE
The multiple neuropathy (cryoglobulinaemia neuropathy), associated with hepatitis C, was treated with corticosteroids (starting with 60 mg/d prednisolone) and the neurological abnormalities regressed well.
CONCLUSION
Vasculitis associated with hepatitis C should be included in the differential diagnosis of peripheral neuropathy.
病史与临床发现
一名56岁的丙型肝炎女性患者出现多发性神经病变症状，表现为肢体不对称性远端轻瘫及疼痛性感觉障碍。
检查
除丙型肝炎血清学阳性外，还检测到冷球蛋白，补体C4降低。腓肠神经活检显示为血管炎性神经病变。
治疗与病程
与丙型肝炎相关的多发性神经病变（冷球蛋白血症性神经病变）采用皮质类固醇治疗（起始剂量为泼尼松龙60mg/d），神经功能异常恢复良好。
结论
丙型肝炎相关血管炎应列入周围神经病变的鉴别诊断。
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