Hepatitis C virus infection with peripheral neuropathy is not always associated with cryoglobulinaemia

Objectives-To describe cases of peripheral neuropathy associated with chron ic hepatitis C virus infection without mixed cryoglobulinaemia. Methods-Four cases of peripheral neuropathy associated with chronic hepatit is C virus infection with persistent negativity of mixed cryoglobulinaemia were found. Results-Ah patients had small increases of transaminase levels and a positi ve viraemia. Liver biopsy showed chronic active hepatitis in all but one ca se (Knodell 4-9, Metavir A0F0-A3F3). Neuromuscular biopsy showed axonal neu ropathy associated with lymphoid infiltrates around small vessels in two ca ses. Rheumatoid factor was always negative and C4 complement level was alwa ys normal. In three patients, neuropathy improved with interferon alpha, in terferon alpha + ursodesoxycholic acid, or steroids + plasma exchange. Conclusion-Peripheral neuropathy may be associated with hepatitis C virus i nfection without mixed cryoglobulinaemia.