Hepatitis B Virus Infectıon Presenting As Chronıc Inflammatory Demyelinating Polyneuropathy

Yıl 2010, Cilt: 12 Sayı: 2, 73 - 77, 01.07.2010

Esra Acıman Osman Korucu Ufuk Emre Nida Fatma Taşçılar

Öz

Chronic inflammatory demyelinating polyneuropathy (CIDP), which is characterized by aprogressive or recurrent loss of motor and sensory peripheral nerves, could be due to manyreasons such as diabetes mellitus, cancer, sarcoidosis. Although, CIDP could develop in patientswith Hepatitis B virus infection (HBVi), HBVi wasnot found to present itself as CIDP. Ourcase is a 60 years old-man whom suddenly developed numbness and weakness in hands andfeet. He was tetraparetic with hypoactive deep tendon reflexes, hypoesthesia and parestesia.Electroneuromyography (ENMG) revealed mixed type demyelinating and sensorialsensorimotor polyneuropathy. At the time of the diagnosis, high values of AST and ALT; lateron, positivity of HBsAg and HBV-DNA were detected. Although liver biopsy showed chronichepatitis and liver fibrosis, he didnot have any history of hepatitis. In conclusion, whileinvestigating the etiology of CIDP, HBVi should be considered even if patients didnot mentionor know any history of hepatitis

Anahtar Kelimeler

Chronic inflammatory demyelinating polyneuropathy, Hepatitis B virus infection, etiology

Kronik İnflamatuar Demiyelinizan Polinöropati İle Presente Olan Hepatit-B Virüs Enfeksiyonu

Öz

Periferik sinirlerin ilerleyici yada tekrarlayıcı, motor ve duyu kaybıyla karakterize olan kronikinflamatuar demiyelinizan polinöropati (KIDP); diabetes mellitus, kanser, sarkoidoz gibinedenlerle gelişebilir. Hepatit B virus enfeksiyonu (HBVe) olan hastalarda KIDP gelişebilir,ancak HBVe’nin KIDP ile presentasyonu bildirilmemiştir. Olgumuz 60 yaşında erkek hasta, elve ayaklarında ani gelişen güçsüzlük ve uyuşukluk şikayeti ile başvurdu. Hastada tetrapareziile birlikte derin tendon reflekslerinde hipoaktivite, hipoestezi ve parestezi mevcuttu. Önce ASTve ALT yüksekliği, ardından da HBsAg ve HBV-DNA pozitifliği saptandı. Karaciğer biyopsisikronik hepatit ve karaciğer fibrosisini göstermesine rağmen, hastada hepatit hikayesi yoktu.Sonuçta, KIDP etiyolojisi araştırılırken, hepatit öyküsü olmasa bile, HBVe düşünülmelidir

Anahtar Kelimeler

Kronik inflamatuar demiyelinizan polinöropati, Hepatit B virusenfeksiyonu, etiyoloji

Kaynakça

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