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Song, Kim, Shin, Hong, Rim, Park, Lee, Lee, Oh, and Hwang: A Case of Severe Peripheral Polyneuropathy Occurring after Entecavir Treatment in a Hepatitis B Patient
Case Report

Korean J Gastroenterol 2016;67(4):216-219.

Published online: 4 October 2016

DOI: https://doi.org/10.4166/kjg.2016.67.4.216

A Case of Severe Peripheral Polyneuropathy Occurring after Entecavir Treatment in a Hepatitis B Patient

Ji Hyun Song1, Si Yeon Kim1, Jae Kyoung Shin2, So Dam Hong2, Kyu Sung Rim1, Ha Na Park1, Joo Ho Lee1, Yun Bin Lee1, Seung Hun Oh3, Seong Gyu Hwang1

1Division of Gastroenterology and Hepatology, CHA University, Seongnam, Korea

2Department of Internal Medicine, CHA University, Seongnam, Korea

3Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea

Correspondence to: Seong Gyu Hwang, Division of Gastroenterology and Hepatology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea. Tel: +82-31-780-5213, Fax: +82-31-780-5219, E-mail: sghwang@cha.ac.kr

Received 22 September 2015       Revised 18 November 2015       Accepted 19 November 2015

Copyright © 2016 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Entecavir (BaracludeⓇ) is an oral antiviral drug used for the treatment of HBV. Entecavir is a reverse transcriptase inhibitor which prevents the HBV from multiplying. Most common adverse reactions caused by entecavir are headache, fatigue, dizziness, and nausea. Until now, there has been no report of peripheral neuropathy as a side effect associated with entecavir treatment. Herein, we report a case of peripheral neuropathy which probably occurred after treatment with entecavir in a hepatitis B patient. The possibility of the occurrence of this side effect should be carefully taken into consideration when a patient takes a high dose of entecavir for a long period of time or has risk factors for neuropathy at the time of initiating entecavir therapy.

Keywords: Entecavir, Polyneuropathies, Hepatitis B

References

1. Levine S, Hernandez D, Yamanaka G, et al. Efficacies of entecavir against lamivudine-resistant hepatitis B virus replication and recombinant polymerases in vitro. Antimicrob Agents Chemother. 2002; 46:2525–2532.
crossref
2. Seifer M, Hamatake RK, Colonno RJ, Standring DN. In vitro inhibition of hepadnavirus polymerases by the triphosphates of BMS-200475 and lobucavir. Antimicrob Agents Chemother. 1998; 42:3200–3208.
crossref
3. Manns MP, Akarca US, Chang TT, et al. Longterm safety and tolerability of entecavir in patients with chronic hepatitis B in the rollover study ETV-901. Expert Opin Drug Saf. 2012; 11:361–368.
crossref
4. Lange CM, Bojunga J, Hofmann WP, et al. Severe lactic acidosis during treatment of chronic hepatitis B with entecavir in patients with impaired liver function. Hepatology. 2009; 50:2001–2006.
crossref
5. Zhang XH, Wu YK, Cao H, Wu ZB, Ke WM. Clinical characterization of peripheral neuropathy associated with entecavir in patients with HBV-induced cirrhosis. Zhonghua Gan Zang Bing Za Zhi. 2012; 20:707–708. Chinese.
6. Shim JH, Lee HC, Kim KM, et al. Efficacy of entecavir in treatmentnaïve patients with hepatitis B virus-related decompensated cirrhosis. J Hepatol. 2010; 52:176–182.
crossref
7. Liaw YF, Raptopoulou-Gigi M, Cheinquer H, et al. Efficacy and safety of entecavir versus adefovir in chronic hepatitis B patients with hepatic decompensation: a randomized, open-label study. Hepatology. 2011; 54:91–100.
crossref
8. Gish RG, Lok AS, Chang TT, et al. Entecavir therapy for up to 96 weeks in patients with HBeAg-positive chronic hepatitis B. Gastroenterology. 2007; 133:1437–1444.
crossref
9. Chang TT, Gish RG, de Man R, et al. BEHoLD AI463022 Study Group. A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B. N Engl J Med. 2006; 354:1001–1010.
crossref

Table 1.
Findings of Motor Nerve Conduction Study
  Latency (msec)
 Amplitude (mV)
Left Right Left Right
Median nerve (ref.) ≤3.9 ≥6.0
 Wrist 15.2 a 15.8 a 2.60 a 2.45 a
 Elbow 20.3 a 20.7 a 2.55 a 2.21 a
 Axilla 22.3 a 22.1 a 2.45 a 2.04 a
Ulnar nerve (ref.) ≤3.0 ≥8.0
 Wrist 5.0 a 5.7 a 5.83 a 6.05 a
 Elbow 9.7 a 10.8 a 4.23 a 5.05 a
 Axilla 12.2 a 12.8 a 4.21 a 4.16 a
Peroneal nerve (ref.) ≤5.3 ≥1.5
 Ankle 19.4 a 15.3 a 0.78 a 1.60
 Fibula head 27.6 a 27.8 a 0.61 a 1.56
Tibial nerve (ref.) ≤5.4 ≥6.0
 Ankle 7.3 a 8.4 a 0.73 a 1.66 a
 Popliteal fossa 19.7 a 19.0 a 0.47 a 1.32 a

ref., reference.

a Abnormal findings.

Table 2.
Findings of Motor Nerve Conduction Velocity
  Conduction velocity (m/sec)
Left   Right
Median nerve (ref.)   ≥50.0  
 Wrist-elbow 44.1 a   46.9 a
 Elbow-axilla 47.5 a   71.4
Ulnar nerve (ref.)   ≥50.0  
 Wrist-elbow 44.6 a   45.0 a
 Elbow-axilla 36.0 a   47.5 a
Peroneal nerve (ref.)   ≥40.0  
 Ankle-fibula head 41.4   25.6 a
Tibial nerve (ref.)   ≥41.0  
 Ankle-popliteal fossa 29.4 a   34.9 a

ref., reference.

a Abnormal findings.

Table 3.
Findings of Sensory Nerve Conduction Study
Variable Amplitude (μ V)
 Conduction velocity (m/sec)
Left Right Left Right
Median nerve (ref.) ≥9.0 ≥39.0
 Index-wrist NP a NP a NP a NP a
 Wrist-elbow 21.38 21.76 51.2 51.2
 Elbow-axilla 42.04 61.92 47.0 50.0
Ulnar nerve (ref.) ≥8.0 ≥38.0
 Short finger-wrist NP a NP a NP a NP a
 Wrist-elbow 22.53 21.31 47.3 47.5
 Elbow-axilla 43.80 78.45 54.7 53.1
Right superficial peroneal nerve (ref.) ≥8.0 ≥39.0
 Lower leg 3.71 a 5.324 a 35.2 a 32.4 a
Right sural nerve (ref.) ≥10.0 ≥32.0
 Lower leg 1.37 a 8.69 a 35.2 35.4

ref., reference; NP, no potential.

a Abnormal findings.

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