Hepatitis E virus infection as a direct cause of neuralgic amyotrophy

ABSTRACT Introduction: We describe a patient who developed neuralgic amyotrophy (NA) related to hepatitis E virus (HEV) infection. Methods: The patient underwent neurological and electrodiagnostic examinations, high‐resolution analysis of serological changes, and HEV load profile, and was treated wi...

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Published in:Muscle & nerve Vol. 54; no. 2; pp. 325 - 327
Main Authors: Silva, Mauro, Wicki, Benoît, Tsouni, Pinelopi, Cunningham, Sophie, Doerig, Christopher, Zanetti, Giorgio, Aubert, Vincent, Sahli, Roland, Moradpour, Darius, Kuntzer, Thierry
Format: Journal Article
Language:English
Published: United States Blackwell Publishing Ltd 01.08.2016
Wiley Subscription Services, Inc
Subjects:
acute cervical radiculoplexopathy
anti-HEV antibody
Brachial Plexus Neuritis - etiology
Brachial Plexus Neuritis - physiopathology
Brachial Plexus Neuritis - virology
Hepatitis
Hepatitis E - complications
Hepatitis E virus
Hepatitis E virus - pathogenicity
HEV RNA
Humans
Infections
intravenous immunoglobulins
Male
neuralgic amyotrophy
neuralgic amyotrophy
intravenous immunoglobulins
HEV RNA
anti-HEV antibody
acute cervical radiculoplexopathy
ISSN:0148-639X, 1097-4598, 1097-4598
Online Access:Get full text
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Summary:ABSTRACT Introduction: We describe a patient who developed neuralgic amyotrophy (NA) related to hepatitis E virus (HEV) infection. Methods: The patient underwent neurological and electrodiagnostic examinations, high‐resolution analysis of serological changes, and HEV load profile, and was treated with intravenous immunoglobulin. Results: There was evidence of bilateral, asymmetric acute inflammatory cervical polyradiculopathy and possible brachial plexopathy. Positive serum anti‐HEV IgM was followed by seroconversion to anti‐HEV IgG positivity. A calculated anti‐HEV antibody index was compatible with intrathecal synthesis, and HEV genotype 3 RNA was found in serum and cerebrospinal fluid (CSF). Liver function tests returned to normal within 6 weeks. Conclusions: Bilateral involvement of cervical nerve roots and/or plexus, elevated liver function tests, and abnormal CSF are typical features of HEV‐associated NA. The pathogenesis involves possible immune‐mediated mechanisms. However, our findings support the hypothesis that HEV‐related NA is associated with direct infection. Muscle Nerve 54: 325–327, 2016
Bibliography:istex:4E74EB87AACD7C271E16155C650D9531B0B99659
ArticleID:MUS25096
ark:/67375/WNG-N6VCRQ51-Q
Drs. Silva and Wicki contributed equally to this work.
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ISSN:0148-639X
1097-4598
1097-4598
DOI:10.1002/mus.25096