Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2024; 12(10): 1766-1771
Published online Apr 6, 2024. doi: 10.12998/wjcc.v12.i10.1766
Demyelinating neuropathy in patients with hepatitis B virus: A case report
Xiao-Xiao Yan, Jin Huang, Jing Lin
Xiao-Xiao Yan, Jin Huang, Jing Lin, Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Ruian 325000, Zhejiang Province, China
Author contributions: Yan XX managed the patient and wrote the manuscript; Huang J participated in data collection and revised the manuscript; Lin J was responsible for clinical management of the patient, and drafted and edited the manuscript; all the authors thoroughly reviewed and gave their approval for the final version of the manuscript.
Informed consent statement: The study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Jing Lin, Doctor, Chief Physician, Doctor, Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, No. 108 Wansong Road, Ruian, 325000, Zhejiang Province, China.
Received: September 16, 2023
Peer-review started: September 16, 2023
First decision: December 5, 2023
Revised: December 17, 2023
Accepted: March 18, 2024
Article in press: March 18, 2024
Published online: April 6, 2024

Hepatitis B rarely leads to demyelinating neuropathy, despite peripheral neuropathy being the first symptom of hepatitis B infection.


A 64-year-old man presented with sensorimotor symptoms in multiple peripheral nerves. Serological testing showed that these symptoms were due to hepatitis B. After undergoing treatment involving intravenous immunoglobulin and an antiviral agent, there was a notable improvement in his symptoms.


Although hepatitis B virus (HBV) infection is known to affect hepatocytes, it is crucial to recognize the range of additional manifestations linked to this infection. The connection between long-term HBV infection and demyelinating neuropathy has seldom been documented; hence, prompt diagnostic and treatment are essential. The patient's positive reaction to immunoglobulin seems to be associated with production of the antigen-antibody immune complex.

Keywords: Hepatitis B virus infection, Extrahepatic manifestations, Demyelinating neuropathy, Intravenous immunoglobulin, Electroneuromyography, Case report

Core Tip: We report an exceptional case of demyelinating neuropathy in an individual with hepatitis B virus (HBV) infection, emphasizing the importance for clinicians to consistently take this into account when making a diagnosis. The underlying disease process and mechanisms of peripheral neuropathy following HBV infection are still unknown. The patient's favorable reaction to immunoglobulin suggests the potential of long-term immune-induced neuropathy.