NONSYSTEMIC VASCULITIC MONONEUROPATHY MULTIPLEX, CRYOGLOBULINEMIA, AND HEPATITIS-C

A 39-year-old man developed sequential acute mononeuropathies involvin g both median, both ulnar, and the right radial and left peroneal nerv es. Electrophysiology demonstrated an asymmetric sensorimotor axonal p olyneuropathy; nerve biopsy confirmed a vasculitis. Laboratory evaluat ion revealed a mixed cryoglobulinemia and active hepatitis C infection . The patient stabilized with prednisone/cyclophosphamide/interferon-a lpha. Hepatitis C should be considered in the differential diagnosis o f mononeuropathy multiplex. Accurate diagnosis is important, as interf eron-alpha may prevent transition to chronic hepatitis/cirrhosis. (C) 1996 John Wiley & Sons, Inc.