T Comont1, D Bonnet1, N Sigur1, A Gerdelat2, F Legrand-Abravanel3, N Kamar4, L Alric5. 1. Service de médecine interne, pôle digestif, CHU Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France. 2. Service de neurologie, CHU Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France. 3. Service de virologie, CHU Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France. 4. Service de néphrologie, dialyse et transplantation d'organes, CHU Rangueil, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France. 5. Service de médecine interne, pôle digestif, CHU Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France. Electronic address: alric.a@chu-toulouse.fr.
Abstract
INTRODUCTION: Hepatitis E virus (HEV) infection is now recognized to be an emerging autochthonous disease in several countries. There have been several reports of neurological manifestations associated with HEV infections. Immunocompromised patients seem to be particularly vulnerable. CASE REPORT: We report a 73-year-old man who presented with an acute polyradiculopathy and an acute hepatitis. HEV RNA was positive in serum and cerebrospinal fluid. Serum antiganglioside antibodies were also detected. Liver function tests returned to normal rapidly and HEV RNA was undetectable 4 weeks after initial testing. The neurological features improved gradually with the use of intravenous immunoglobulins. CONCLUSION: We report a case of Guillain-Barré syndrome related to acute hepatitis E in an immunocompetent patient. The outcome was favorable after intravenous immunoglobulins administration. HEV screening should be systematic in patients who present with an acute polyradiculopathy and abnormal liver function tests.
INTRODUCTION:Hepatitis E virus (HEV) infection is now recognized to be an emerging autochthonous disease in several countries. There have been several reports of neurological manifestations associated with HEV infections. Immunocompromised patients seem to be particularly vulnerable. CASE REPORT: We report a 73-year-old man who presented with an acute polyradiculopathy and an acute hepatitis. HEV RNA was positive in serum and cerebrospinal fluid. Serum antiganglioside antibodies were also detected. Liver function tests returned to normal rapidly and HEV RNA was undetectable 4 weeks after initial testing. The neurological features improved gradually with the use of intravenous immunoglobulins. CONCLUSION: We report a case of Guillain-Barré syndrome related to acute hepatitis E in an immunocompetent patient. The outcome was favorable after intravenous immunoglobulins administration. HEV screening should be systematic in patients who present with an acute polyradiculopathy and abnormal liver function tests.
Authors: Harry R Dalton; Nassim Kamar; Jeroen J J van Eijk; Brendan N Mclean; Pascal Cintas; Richard P Bendall; Bart C Jacobs Journal: Nat Rev Neurol Date: 2015-12-29 Impact factor: 42.937