Confluent peripheral multiple mononeuropathy associated to acute hepatitis B: a case report

Authors

  • Marcello CANIELLO São Paulo University; School of Medicine
  • Patrícia BAXTER FMUSP; Hospital das Clínicas; Clinical Division of Infectious and Parasitic Diseases
  • Angelina Maria Martins LINO FMUSP; Hospital das Clínicas; Department of Neurology
  • Leandro Gregorut LIMA São Paulo University; School of Medicine
  • Walkyria Pereira PINTO Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Department of Infectious and Parasitic Diseases

Keywords:

Peripheral neuropathy, Hepatitis B, Denervation

Abstract

A thirty three year-old, male patient was admitted at the Hospital of the São Paulo University School of Medicine, at the city of São Paulo, Brazil, with complaint of pains, tingling and decreased sensibility in the right hand for the last four months. This had progressed to the left hand, left foot and right foot, in addition to a difficulty of flexing and stretching in the left foot. Tests were positive for HBeAg, IgM anti-HBc and HBsAg, thus characterizing the condition of acute hepatitis B. The ALT serum level was 15 times above the upper normal limit. Blood glucose, cerebral spinal fluid, antinuclear antibodies (ANA) and anti-HIV and anti-HCV serum tests were either normal or negative. Electroneuromyography disclosed severe peripheral neuropathy with an axon prevalence and signs of denervation; nerve biopsy disclosed intense vasculitis. The diagnosis of multiple confluent mononeuropathy associated to acute hepatitis B was done. This association is not often reported in international literature and its probable cause is the direct action of the hepatitis B virus on the nerves or a vasculitis of the vasa nervorum brought about by deposits of immune complexes.

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Published

2002-01-01

Issue

Section

Case Report

How to Cite

Confluent peripheral multiple mononeuropathy associated to acute hepatitis B: a case report . (2002). Revista Do Instituto De Medicina Tropical De São Paulo, 44(3), 171-173. https://www.revistas.usp.br/rimtsp/article/view/30580