Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Jul 17;19(1):636.
doi: 10.1186/s12879-019-4278-7.

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

Alexandre Chlilek  1 , Claire Roger  2 , Laurent Muller  2 , Marie-Josée Carles  1 , Robin Stephan  1 , Didier Laureillard  3 , Jean-Philippe Lavigne  4   5 , Jean-Yves Lefrant  2 , Albert Sotto  3   6
Affiliations
Case Reports

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

Alexandre Chlilek et al. BMC Infect Dis. .

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.

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

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Medical history and treatment of a severe Guillain-Barre syndrome (GBS) associated with chronic active hepatitis C with mixed cryoglobulinemia. Abs Antibodies; VL Viral Load; ICU Intensive Care Unit, IV Igs Intravenous immunoglobulins, DAA Direct-acting antiviral, QD Once a day
See this image and copyright information in PMC

References

    1. Lanini S, Easterbrook PJ, Zumla A, Ippolito G. Hepatitis C: global epidemiology and strategies for control. Clin Microbiol Infect. 2016;22(10):833–838. doi: 10.1016/j.cmi.2016.07.035. - DOI - PubMed
    1. Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014;61(Suppl 1):S58–S68. doi: 10.1016/j.jhep.2014.07.012. - DOI - PubMed
    1. Cacoub P, Gragnani L, Comarmond C, Zignego AL. Extrahepatic manifestations of chronic hepatitis C virus infection. Dig Liver Dis. 2014;46(Suppl 5):S165–S173. doi: 10.1016/j.dld.2014.10.005. - DOI - PubMed
    1. Mathew S, Faheem M, Ibrahim SM, Iqbal W, Rauff B, Fatima K, et al. Hepatitis C virus and neurological damage. World J Hepatol. 2016;8(12):545–556. doi: 10.4254/wjh.v8.i12.545. - DOI - PMC - PubMed
    1. Adinolfi LE, Nevola R, Lus G, Restivo L, Guerrera B, Romano C, et al. Chronic hepatitis C virus infection and neurological and psychiatric disorders: an overview. World J Gastroenterol. 2015;21(8):2269–2280. doi: 10.3748/wjg.v21.i8.2269. - DOI - PMC - PubMed

Publication types

MeSH terms

Substances