Autoimmune hepatitis complicated with entrapment neuropathy & fibromyalgia: A case report

Abstract

46. y-old right-handed female with history of controlled autoimmune hepatitis since 2001 with negative liver biopsy on 2017 presented with chronic generalized pain affecting neck, upper back, buttocks, knee and chest associated with paresthesia and tingling of left hand with nocturnal exacerbation. Clinical exam revealed; Neurologically Positive Tinel sign over median nerve at wrist bilaterally, Positive Phalen test bilaterally, Musculoskeletal exam revealed multiple tender points bilaterally with limited neck Rom due to pain. Electrophysiological testing of both upper extremities documented bilateral median sensory neuropathy at wrist, demyelinating pathology and bilateral ulnar nerve entrapment at wrist: Guyon canal syndrome; sensory-motor axonal demyelinating. Normal liver and kidney function tests and glycosylated hemoglobin 5.