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A 39-year-old man developed sequential acute mononeuropathies involving both median,both ulnar,and the right radial and left peroneal nerves. Electrophysiology demonstrated an asymmetric sensorimotor axonal polyneuropathy;nerve biopsy confirmed a vasculitis.Laboratory evaluation revealed a mixed cryoglobulinemia and active hepatitis C infection.The patient stabilized with prednisone/cyclophosphamide/interferon-a.Hepatitis C should be considered in the differential diagnosis of mononeuropathy multiplex.Accurate diagnosis is important,as interferon-a may prevent transition to chronic hepatitis/cirrhosis. |
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