Neuropathies in relation to Serum Cobalamin in Chronic Hepatitis C Patients.

This study aimed to investigate the incidence and characteristics of peripheral neuropathy in chronic hepatitis C patients and its relation to serum cobalamin. Fifty patients (32 males, 18 females) aged 22-26 years with HCV related chronic disease were divided into 2 groups: Group I - MELD<14, Group II - MELD>14, Group III control. Cardiovascular autonomic function tests were performed to assess presence or absence of autonomic neuropathy. All patients underwent nerve conduction studies (NCS). Patients with Diabetes Mellitus, chronic renal failure, malignancy, history of alcohol intake, receiving neurotoxic drugs as chemotherapy were excluded from the study. The abnormalities were sensory abnormalities (22%), motor abnormalities (18%), both sensory and motor abnormalities (10%). Moreover, 46% had evidence of neuropathy, 30% had dysautonomia, 36% had peripheral neuropathy and 20% had both peripheral and autonomic neuropathy. Neuropathy was seen irrespective of the cause of liver disease and there was a significant correlation of the severity of neuropathy to severity of liver disease suggesting that the metabolic dysfunction caused by liver disease is the primary determinant of polyneuropathy. It was found that serum B12 was above normal level and very high in liver cirrhosis. No relation was found between serum B12 and neuropathy in hepatic patients.