HIGH PREVALENCE OF PERIPHERAL NEUROPATHY IN HEPATITIS-C VIRUS-INFECTED PATIENTS WITH SYMPTOMATIC AND ASYMPTOMATIC CRYOGLOBULINEMIA

Background. Fifty per cent of patients with chronic hepatitis C, show detectable cryoglobulinaemia, even though most of them do not show cry oglobulinaemia related symptoms. Peripheral neuropathy is present in m ost of the patients with symptomatic cryoglobulinaemia, where it may b e the first clinical manifestation. The prevalence of peripheral neuro pathy in patients with hepatitis C and cryoglobulinaemia is unknown. A ims. To assess the prevalence of peripheral neuropathy in HCV infected patients with symptomatic or asymptomatic detectable cryoglobulinaemi a. Patients and Methods. Eighty-nine patients with HCV infection and d etectable cryoglobulinaemia underwent electrophysiological studies. Re sults. Electrophysiological evidence of peripheral neuropathy was foun d in 37% and was significantly associated with: the presence of cryogl obulinaemia syndrome, older age, higher rheumatoid factor reactivity a nd immunoglobulin M levels and reduced complement C-4 activity. Howeve r electrophysiological evidence of peripheral neuropathy was unrelated to cryocrit levels and type of cryoglobulinaemia and was found in 23/ 68 patients without any symptoms of cryoglobulinaemia other than pain and paresthesia. Conclusions. These findings suggest that peripheral n europathy is frequent in patients with hepatitis C and detectable cryo globulins. Neuropathy was found to be present in 1/3 of patients witho ut other cryoglobulinaemia-related symptoms, thus a direct or indirect role of HCV, independent of cryoglobulinaemia, in the pathogenesis of nerve damage cannot be ruled out.