Hepatitis B Virus-related Vasculitic Neuropathy in an Inactive Virus Carrier Treated with Intravenous Immunoglobulin
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- Kusama Kaori
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Nakae Yoshiharu
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Tada Mikiko
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Higashiyama Yuichi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Miyaji Yosuke
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Yamaura Genpei
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Kunii Misako
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Tanaka Kenichi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Ohyama Ken
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
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- Koike Haruki
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
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- Joki Hideto
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Doi Hiroshi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Koyano Shigeru
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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- Tanaka Fumiaki
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan
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Abstract
<p>We herein report a 33-year-old woman who was an asymptomatic hepatitis B virus (HBV) carrier and presented with distal muscle weakness in the legs and asymmetrical paresthesia in the distal extremities. A nerve biopsy specimen revealed fibrinoid necrosis associated with inflammatory infiltration in the perineural space, and deposition of hepatitis B core antigen and C4d complement was detected in the vascular endothelial cells as well as around the vessels. She was diagnosed with HBV-related vasculitic neuropathy and treated with intravenous immunoglobulin (IVIG). Her symptoms completely subsided after eight weeks. Vasculitic neuropathy rarely develops in the chronic inactive stages of HBV infection. This is the first report of an HBV-inactive carrier with vasculitic neuropathy successfully treated with IVIG. </p>
Journal
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- Internal Medicine
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Internal Medicine 59 (23), 3075-3078, 2020-12-01
The Japanese Society of Internal Medicine