Severe Guillain-Barré syndrome associated with chronic active hepatitis C and mixed cryoglobulinemia: a case report

BMC Infectious Diseases

Didier Laureillard¹  Albert Sotto¹  Robin Stephan²  Alexandre Chlilek²  Jean-Philippe Lavigne²  Marie-Josée Carles²  Laurent Muller³  Claire Roger³  Jean-Yves Lefrant³ 

[1] Service de Maladies Infectieuses et Tropicales, CHU Carémeau;Service de Microbiologie, CHU Carémeau;Service de Réanimation Chirurgicale, CHU Carémeau;

关键词: Chronic hepatitis C;    Hepatitis C virus;    Guillain-Barre syndrome;    Mixed cryoglobulinemia;    Extra-hepatic manifestations;   

DOI  :  10.1186/s12879-019-4278-7

来源: DOAJ

【 摘 要 】

Abstract Background We describe a case of severe Guillain-Barre syndrome (GBS) associated with chronic active hepatitis C and mixed cryoglobulinemia (MC). To our knowledge, this association between GBS and hepatitis C virus (HCV) infection has been rarely reported. Case presentation A 56-year-old man developed symmetrical muscle weakness in all extremities, areflexia and sensorial disorder followed by acute respiratory failure associated with chronic active hepatitis C, which was confirmed by the presence of anti-HCV antibodies in the serum and persistence of HCV RNA viral load for more than 6 months. Chronic hepatitis C was further complicated by type 3 MC. Electromyography showed peripheral nerve injury (mainly in axon). A severe acute motor sensory axonal neuropathy (AMSAN) was diagnosed. After treatment with intravenous immunoglobulin and plasma exchange followed by antiviral therapy by direct-acting antiviral agent, patient showed progressive recovery and was transferred 3 months after his first admission to a rehabilitation center. Conclusions Our case reported a severe GBS associated with HCV infection and MC. EMG classified for the first time the subtype of GBS (severe AMSAN) correlated with severe clinical form. HCV infection should be screened in high-risk patients to prevent silent progression of the chronic hepatitis C and its potentially severe extra-hepatic manifestations.

【 授权许可】

Unknown