PCR DETECTED HEPATITIS-C VIRUS GENOME IN THE BRAIN OF A CASE WITH PROGRESSIVE ENCEPHALOMYELITIS WITH RIGIDITY

A case of progressive encephalomyelitis with rigidity (PEWR) associate d with hepatitis C virus (HCV) is reported. A 58 year-old woman presen ted with a clinical picture of progressive quadriparesis, sensory loss , sphincter dysfunction, painful muscle spasms in the upper and lower limbs and continuous muscle unit activity in electromyography. She dev eloped hepatitis, pancreatitis and HCV-RNA was detected in the plasma by reverse transcription-polymerase chain reaction (RT-PCR). Postmorte m histopathological examination showed encephalomyelitis with perivasc ular lymphocyte cuffing, infiltration and neuronal loss mainly affecti ng the brainstem and cervical spinal cord. The RT-PCR analysis of the postmortem brain, brainstem, liver, pancreas, plasma and CSF samples r evealed the presence of HCV genome in all specimens except CSF. Clinic al features, postmortem histopathology and PCR results and the possibl e etiopathogenesis of PEWR are briefly discussed.