Treatment of mononeuropathy multiplex in hepatitis C virus and cryoglobulinemia

Scelsa, Stephen N.; Herskovitz, Steven; Reichler, B

doi:10.1002/(sici)1097-4598(199811)21:11<1526::aid-mus23>3.0.co;2-x

Cited by 25 publications

(8 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 4 In these instances, immunosuppressive treatment of MC with corticosteroids or cyclophosphamide is often needed. 9 Pulse cyclophosphamide produced a decrease in the cryocrit and complement activation, a temporary improvement of vasculitis, regression of neuropathy in one patient, but also caused minor flares of hepatitis C. Patients resistant to intravenous pulse cyclophosphamide may respond to oral cyclophosphamide and plasmapheresis, as recently reported. 10 However, as Table 1 Genetic identities and distances of amino acids and nucleotides in the hypervariable region 1 of HCV in the cryoprecipitate before and after six months of pulse cyclophosphamide treatment of cryoglobulinaemic vasculitis in patients A and B, calculated by BioEdit version 5.0.9.…”

Section: Discussionsupporting

confidence: 56%

“…As in our patients, exacerbation of cryoglobulinaemia related ischaemic and neurologic manifestations during IFNα treatment have been reported previously. 9 Besides the ability to induce polyneuropathy, IFNα also may impair the revascularisation of ischaemic organs. 2 4 In these instances, immunosuppressive treatment of MC with corticosteroids or cyclophosphamide is often needed.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Kinetics of hepatitis C (HCV) viraemia and quasispecies during treatment of HCV associated cryoglobulinaemia with pulse cyclophosphamide

Thiel

Peters²,

Marques³

et al. 2002

Annals of the Rheumatic Diseases

View full text Add to dashboard Cite

Objective: To investigate the effect of pulse cyclophosphamide treatment on hepatitis C virus (HCV) kinetics and quasispecies in interferon α (IFNα) resistant HCV related cryoglobulinaemic vasculitis. Methods: Reports on two patients with severe manifestations of HCV related cryoglobulinaemia who failed to respond to interferon α are given. Both patients were treated with pulse cyclophosphamide (750-1000 mg/ month for six and 11 months, respectively). HCV RNA was quantified and HCV quasispecies determined in cryoprecipitates and supernatants before and during treatment. Results: Cryocrit and complement activation decreased in both patients with rebound of cryocrit in one case during continuing pulse cyclophosphamide treatment. Vasculitic symptoms improved. Alanine aminotransferase (ALT) levels and HCV viral load (0.2-0.4 log) increased slightly and reached pretreatment levels after cyclophosphamide was stopped. A highly heterogeneous quasispecies was found in the cryoprecipitate and supernatant of one patient, whereas the viral population was homogeneous in the other patient. After six cycles of cyclophosphamide, viral distances decreased non-significantly. However, phylogenetic analysis showed the evolution of distinct viral strains in one patient and replacement of the main viral population by another population in the second patient. Conclusions: Immunosuppressive treatment with pulse cyclophosphamide has a temporary limited effect on HCV associated cryoglobulinaemia and leads to a reversible increase of ALT levels and HCV viral load. Short term immunosuppression does not affect the viral heterogeneity as measured by amino acid and nucleotide distances in the hypervariable region 1 of HCV. A change of quasispecies was observed, but further studies are needed to evaluate if this does affect the outcome of IFNα treatment in such patients.

show abstract

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Kinetics of hepatitis C (HCV) viraemia and quasispecies during treatment of HCV associated cryoglobulinaemia with pulse cyclophosphamide

Thiel

Peters²,

Marques³

et al. 2002

Annals of the Rheumatic Diseases

View full text Add to dashboard Cite

show abstract

“…Some findings indicate that PN improves during treatment with IFN [50,[52][53]; in other studies, however, IFN has caused worsening of PN in patients with HCV and MC [54]. PN has even been suggested as a possible side effect of IFN treatment [55].…”

Section: Hepatitis C Virus and Peripheral Neuropathymentioning

confidence: 99%

A closer look at pain and hepatitis C: Preliminary data from a veteran population

Silberbogen¹,

Janke²,

Hebenstreit³

2007

JRRD

View full text Add to dashboard Cite

Abstract-An association between the hepatitis C virus (HCV) and various pain diagnoses, including arthritis, fibromyalgia, and peripheral neuropathy, has been reported. In this article, we review the literature on the relationship between HCV and pain, highlighting current knowledge as well as methodological issues that exist in many studies. We also present preliminary findings from a survey conducted at two Department of Veterans Affairs facilities to assess the scope and impact of pain on functioning in veterans with HCV. Our results indicate that pain is very prevalent within this population and that HCV-positive veterans who experience persistent pain have significant depressive symptoms and engage in highrisk behaviors, such as cigarette smoking and alcohol use. Finally, we draw upon our review and preliminary results to propose areas of future rehabilitative research and to address the implications for clinicians working with patients with comorbid HCV and pain.

show abstract

“…Hepatitis B virus associated vasculitis is treated with interferon-α2b or lamivudine and plasma exchange,142 and hepatitis C with pegylated interferon-α2b or -α2a and ribavarin 143 144. Rituximab is showing promise for systemic vasculitis with and without cryoglobulinaemia 145 146…”

Section: Vasculitic Neuropathymentioning

confidence: 99%

Diagnosis and treatment in inflammatory neuropathies

Lunn

Willison

2009

Postgraduate Medical Journal

View full text Add to dashboard Cite

The inflammatory neuropathies are a large diverse group of immune-mediated neuropathies that are amenable to treatment and may be reversible. Their accurate diagnosis is essential for informing the patient of the likely course and prognosis of the disease, informing the treating physician of the appropriate therapy and informing the scientific community of the results of well-targeted, designed and performed clinical trials. With the advent of biological therapies able to manipulate the immune response more specifically, an understanding of the pathogenesis of these conditions is increasingly important. This review presents a broad overview of the pathogenesis, diagnosis and therapy of inflammatory neuropathies, concentrating on the most commonly encountered conditions.

show abstract

Treatment of mononeuropathy multiplex in hepatitis C virus and cryoglobulinemia

Cited by 25 publications

References 17 publications

Kinetics of hepatitis C (HCV) viraemia and quasispecies during treatment of HCV associated cryoglobulinaemia with pulse cyclophosphamide

Kinetics of hepatitis C (HCV) viraemia and quasispecies during treatment of HCV associated cryoglobulinaemia with pulse cyclophosphamide

A closer look at pain and hepatitis C: Preliminary data from a veteran population

Diagnosis and treatment in inflammatory neuropathies

Contact Info

Product

Resources

About