• Kaori Kusama, Yoshiharu Nakae, Mikiko Tada, Yuichi Higashiyama, Yosuke Miyaji, Genpei Yamaura, Misako Kunii, Kenichi Tanaka, Ken Ohyama, Haruki Koike, Hideto Joki, Hiroshi Doi, Shigeru Koyano, and Fumiaki Tanaka.
• Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Japan.
• Intern. Med. 2020 Dec 1; 59 (23): 3075-3078.

AbstractWe 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.

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