Jeroen J J van Eijk1, Richie G Madden, Annemiek A van der Eijk, Jeremy G Hunter, Johan H J Reimerink, Richard P Bendall, Suzan D Pas, Vic Ellis, Nens van Alfen, Laura Beynon, Lucy Southwell, Brendan McLean, Bart C Jacobs, Baziel G M van Engelen, Harry R Dalton. 1. From the Department of Neurology (J.J.J.v.E., N.v.A., B.G.M.v.E.), Radboud University Nijmegen Medical Centre; Department of Neurology (J.J.J.v.E.), Jeroen Bosch Hospital, Nijmegen, the Netherlands; Cornwall Gastrointestinal Unit (R.G.M., J.G.H., L.B., L.S., H.R.D.), Clinical Microbiology (R.P.B., V.E.), and Department of Neurology (B.M.), Royal Cornwall Hospital Trust; European Centre for the Environment and Human Health (R.G.M., J.G.H., R.P.B., L.B., H.R.D.), University of Exeter Medical School, Truro, UK; Centre for Infectious Disease Control (J.H.J.R.), Division Virology, National Institute for Public Health and the Environment, Bilthoven; Departments of Viroscience (A.A.v.d.E., S.D.P.), Immunology (B.C.J.), and Neurology (B.C.J.), Erasmus Medical Centre, University Medical Center Rotterdam, the Netherlands.
Abstract
OBJECTIVE: To determine whether there is an association between an acute preceding hepatitis E virus (HEV) infection and neuralgic amyotrophy (NA), and if so, whether patients with HEV-related NA differ from patients without an associated HEV infection. METHODS: HEV testing was conducted in a retrospective cohort of 28 Cornish patients with NA (2011-2013) and a prospective cohort of 38 consecutive Dutch patients with NA (2004-2007). Acute-phase serum samples were analyzed for the presence of anti-HEV immunoglobulin (Ig) M and IgG and HEV RNA (quantitative real-time PCR). RESULTS: Five cases (10.6%) of acute hepatitis E infection were identified in a total group of 47 patients with NA of whom serum samples were available. In 4 patients, HEV RNA was detected in serum samples taken at presentation. All patients with HEV-associated NA had clinical and electrophysiologic evidence of bilateral brachial plexus involvement. Anti-HEV IgM positivity was not related to age, sex, disease severity, disease course, or outcome. CONCLUSIONS: Acute hepatitis E is found in 10% of patients with NA from the United Kingdom and the Netherlands. Further research is required to investigate the role of HEV in NA in other geographical locations and to determine pathophysiologic mechanisms.
OBJECTIVE: To determine whether there is an association between an acute preceding hepatitis E virus (HEV) infection and neuralgic amyotrophy (NA), and if so, whether patients with HEV-related NA differ from patients without an associated HEV infection. METHODS:HEV testing was conducted in a retrospective cohort of 28 Cornish patients with NA (2011-2013) and a prospective cohort of 38 consecutive Dutch patients with NA (2004-2007). Acute-phase serum samples were analyzed for the presence of anti-HEV immunoglobulin (Ig) M and IgG and HEV RNA (quantitative real-time PCR). RESULTS: Five cases (10.6%) of acute hepatitis E infection were identified in a total group of 47 patients with NA of whom serum samples were available. In 4 patients, HEV RNA was detected in serum samples taken at presentation. All patients with HEV-associated NA had clinical and electrophysiologic evidence of bilateral brachial plexus involvement. Anti-HEV IgM positivity was not related to age, sex, disease severity, disease course, or outcome. CONCLUSIONS: Acute hepatitis E is found in 10% of patients with NA from the United Kingdom and the Netherlands. Further research is required to investigate the role of HEV in NA in other geographical locations and to determine pathophysiologic mechanisms.
Authors: Samreen Ijaz; Eve Arnold; Malcolm Banks; Richard P Bendall; Matthew E Cramp; Richard Cunningham; Harry R Dalton; Tim J Harrison; Simon F Hill; Lorna Macfarlane; Rolf E Meigh; Shuja Shafi; Martin J Sheppard; Jacquie Smithson; Melanie P Wilson; Chong-Gee Teo Journal: J Infect Dis Date: 2005-08-22 Impact factor: 5.226
Authors: C J Klein; P J B Dyck; S M Friedenberg; T M Burns; A J Windebank; P J Dyck Journal: J Neurol Neurosurg Psychiatry Date: 2002-07 Impact factor: 10.154
Authors: G A Suarez; C Giannini; E P Bosch; R J Barohn; J Wodak; P Ebeling; R Anderson; P E McKeever; M B Bromberg; P J Dyck Journal: Neurology Date: 1996-02 Impact factor: 9.910
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
Authors: A Velay; W Kack-Kack; F Abravanel; S Lhomme; P Leyendecker; L Kremer; P Chamouard; J Izopet; S Fafi-Kremer; H Barth Journal: J Neurovirol Date: 2017-04-24 Impact factor: 2.643
Authors: Heléne Norder; Marie Karlsson; Åsa Mellgren; Jan Konar; Elisabeth Sandberg; Anders Lasson; Maria Castedal; Lars Magnius; Martin Lagging Journal: J Clin Microbiol Date: 2015-12-09 Impact factor: 5.948