Hepatitis E and neuralgic amyotrophy: Five cases and review of literature

Abstract : Hepatitis E virus infection - mainly genotype 3 - is increasingly common in industrialized countries. Infection is usually asymptomatic, but cases of central or peripheral neurological symptoms with hepatitis E have been described. The most frequent is Guillain-Barre but somes cases of neuralgic amyotrophy have been described. In our center, since 2010, we have identified five cases of neuralgic amyotrophy associated with acute hepatitis E in immunocompetent patients. For all these patients, neuralgic amyotrophy was diagnosed with electromyogram and positive IgM for hepatitis E, and detectable HEV RNA in 4 of the cases. Including our patients, we count 26 cases in literature. The mean age of the patients was 44 years old, with a large predominance of males (88%). The disorder is bilateral and asymmetric in 69% of cases. Peripheral nerves other than the brachial plexus were affected in 6 patients (23%). In industrialized countries, any neuralgic amyotrophy, particularly if there is bilateral, asymmetric associated with involvement of nerves outside the brachial plexus, should lead physicians to consider a diagnosis of acute hepatitis E.
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Submitted on : Monday, March 11, 2019 - 8:52:34 AM
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Anaïs Dartevel, Barbara Colombe, Annick Bosseray, Sylvie Larrat, Françoise Sarrot-Reynauld, et al.. Hepatitis E and neuralgic amyotrophy: Five cases and review of literature. Journal of Clinical Virology, Elsevier, 2015, 69, pp.156-164. ⟨10.1016/j.jcv.2015.06.091⟩. ⟨hal-02063220⟩

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