Hepatitis B Virus-related Vasculitic Neuropathy in an Inactive Virus Carrier Treated with Intravenous Immunoglobulin

Intern Med. 2020 Dec 1;59(23):3075-3078. doi: 10.2169/internalmedicine.4498-20. Epub 2020 Aug 4.

Abstract

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.

Keywords: hepatitis B virus (HBV); intravenous immunoglobulin (IVIG); vasculitic neuropathy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Carrier State*
  • Endothelial Cells / pathology
  • Female
  • Hepatitis B / complications*
  • Hepatitis B virus
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Peripheral Nervous System Diseases / etiology*
  • Peripheral Nervous System Diseases / virology
  • Vasculitis / etiology*
  • Vasculitis / virology

Substances

  • Immunoglobulins, Intravenous