Case Report
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World J Gastroenterol. Jan 14, 2012; 18(2): 188-191
Published online Jan 14, 2012. doi: 10.3748/wjg.v18.i2.188
Central nervous system vasculitis and polyneuropathy as first manifestations of hepatitis C
Roberto J Carvalho-Filho, Janaína Luz Narciso-Schiavon, Luciano HL Tolentino, Leonardo L Schiavon, Maria Lucia G Ferraz, Antonio Eduardo B Silva
Roberto J Carvalho-Filho, Janaína Luz Narciso-Schiavon, Luciano HL Tolentino, Leonardo L Schiavon, Maria Lucia G Ferraz, Antonio Eduardo B Silva, Division of Gastroenterology, Hepatitis Section, Federal University of Sao Paulo, 04037-003 Sao Paulo, Brazil
Author contributions: Carvalho-Filho RJ, Narciso-Schiavon JL, Tolentino LHL and Schiavon LL designed and performed research and wrote the paper; and Ferraz MLG and Silva AEB analyzed the data and reviewed the paper.
Correspondence to: Roberto J Carvalho-Filho, MD, PhD, Division of Gastroenterology, Hepatitis Section, Federal University of Sao Paulo, Rua Dr. Diogo de Faria, 929, apto 14, 04037-003 Sao Paulo, Brazil. roberto.jcf@uol.com.br
Telephone: +55-11-50837174 Fax: +55-11-55719210
Received: April 11, 2011
Revised: July 9, 2011
Accepted: July 16, 2011
Published online: January 14, 2012
Abstract

Sensory or motor peripheral neuropathy may be observed in a significant proportion of hepatitis C virus (HCV)-infected patients. However, central nervous system (CNS) involvement is uncommon, especially in cryoglobulin-negative subjects. We describe a case of peripheral neuropathy combined with an ischemic CNS event as primary manifestations of chronic HCV infection without cryoglobulinemia. Significant improvement was observed after antiviral therapy. We discuss the spectrum of neurological manifestations of HCV infection and review the literature.

Keywords: Hepatitis C; Central nervous system; Polyneuropathy; Interferon-α