Acute autonomic and sensory neuropathy after interferon alpha-2b therapy for chronic hepatitis C

Irioka, Takashi

doi:10.1136/jnnp.70.3.408

Cited by 31 publications

(23 citation statements)

References 4 publications

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“…Another patient with an antecedent upper respiratory tract infection had testicular cancer 59. Skin eruption may also precede the onset of the disease 14 63 66. Patients who had antecedent events other than infectious diseases (eg, abortion and interferon therapy) have also been reported 14 66.…”

Section: Primary Autonomic Neuropathiesmentioning

confidence: 99%

The spectrum of immune-mediated autonomic neuropathies: insights from the clinicopathological features: Table 1

Koike

Watanabe

Sobue

2012

J Neurol Neurosurg Psychiatry

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Although autonomic neuropathy may occur as a secondary consequence of various diseases, other patients without any obvious underlying diseases show profound autonomic dysfunctions from the early phase of the disease. These idiopathic or primary cases are divided into pure autonomic neuropathy, autonomic neuropathy with sensory impairment, and autonomic neuropathy with sensory and motor impairment based on the concomitance or absence of sensory or motor dysfunctions. The discovery of the antiganglionic acetylcholine receptor antibody suggested the involvement of immune mechanisms in idiopathic cases, especially in those cases with pure autonomic neuropathy. The ability to test for the presence of this antibody has significantly expanded the concept of autonomic neuropathy to include cases with a chronic progressive course that mimics pure autonomic failure. Recent work based on the antiganglionic acetylcholine receptor antibody has established autoimmune autonomic ganglionopathy as an isolated nosological entity. Other forms of primary autonomic neuropathies include acute autonomic and sensory neuropathy and acute autonomic sensory and motor neuropathy, although the nosological relationship of the latter to Guillain-Barré syndrome should be discussed. Although the possibility of infectious, metabolic or toxic aetiologies should be carefully excluded in these forms of autonomic neuropathy, the monophasic clinical course and the presence of antecedent infections suggest the involvement of immune mechanisms similar to Guillain-Barré syndrome. Neuronopathy in the autonomic ganglia is considered to be a common pathology in these autonomic neuropathies. In addition, clinically significant autonomic neuropathy may be associated with pre-existing immunological diseases such as paraneoplastic syndrome and Sjögren's syndrome. An overlap with autoimmune autonomic ganglionopathy has been suggested in these settings.

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Section: Primary Autonomic Neuropathiesmentioning

confidence: 99%

The spectrum of immune-mediated autonomic neuropathies: insights from the clinicopathological features: Table 1

Koike

Watanabe

Sobue

2012

J Neurol Neurosurg Psychiatry

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“…Induction or worsening of peripheral neuropathy has been reported in MC patients treated with rIFN-a2b [13,14]. However, our results should be confirmed by further investigations on larger series.…”

Section: Discussionmentioning

confidence: 41%

Autonomic neuropathy in mixed cryoglobulinemia

Ammendola

Sampaolo

Migliaresi³

et al. 2007

J Neurol

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A retrospective, cross-sectional study was performed on a series of HCV-related mixed cryoglobulinemia (HCV-MC) patients to assess autonomic neuropathy (AN) and its relation to peripheral neuropathy (PN). Thirty consecutive patients affected by HCV-MC underwent clinical, neurological and electrodiagnostic examinations. Autonomic nervous system (ANS) involvement was assessed by functional cardiovascular tests and sympathetic skin response (SSR) evaluation. Sural nerve biopsy was performed in 10 patients with PN. All patients received steroids, 15 also received recombinant interferon-alpha2b (RIfn-alpha2b). PN occurred in 27 patients (90.0%) and AN in 4 (13.3 %) all with signs of PN. SSR was the autonomic test more frequently altered. Biopsy disclosed axonal degeneration more evident in the 4 patients with AN. Three out of 4 patients with AN received steroids and rIFN-alpha2b and 1 steroids alone. In our study on HCV-MC, it was concluded that AN can occur also without dysautonomic symptoms, SSR appears to be one of the optional tests to use together with dysautonomic tests to identify AN and finally PN and AN do not seem to be positively influenced by addition of rIFN-alpha2b to steroid treatment.

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“…Shown is a sagittal T2-weighted image from MRI scan of cervical spine illustrating hyperintense signal extending throughout the cervical cord alpha has been used to treat HCV-associated neuropathy, it has also been shown to cause exacerbations in some patients. All forms of neuropathy have been exacerbated by the use of interferon-alpha, including cryoglobulinemic neuropathy [102], vasculitic neuropathy [66], axonal neuropathy [103], and demyelinating neuropathy [104]. For all instances of neuropathy associated with interferon-alpha, the initial treatment is withdrawal of the interferon.…”

Section: Neurological Complications Of Antiviral Treatmentmentioning

confidence: 99%

Neurological Complications of Hepatitis C Infection

McCarthy

Ortega

2012

Curr Neurol Neurosci Rep

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Though well-known as a cause of liver disease, Hepatitis C virus infection is emerging as a cause of a variety of peripheral and central nervous system disorders. The virus causes chronic persistent infection with complex immune responses in the majority of individuals. Viral infection may have the potential to generate neurological illness through direct infection of neural cells or through immune-mediated mechanisms, including enhancement of autoimmune responses. Moreover, the mainstay of antiviral treatment of hepatitis C infection, interferon-alpha, is itself associated with neurological morbidity. Thus neurologists are increasingly faced with diagnosing or even predicting a wide spectrum of neurological complications of hepatitis C infection and/or its treatment.

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Acute autonomic and sensory neuropathy after interferon alpha-2b therapy for chronic hepatitis C

Cited by 31 publications

References 4 publications

The spectrum of immune-mediated autonomic neuropathies: insights from the clinicopathological features: Table 1

The spectrum of immune-mediated autonomic neuropathies: insights from the clinicopathological features: Table 1

Autonomic neuropathy in mixed cryoglobulinemia

Neurological Complications of Hepatitis C Infection

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