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

J Clin Virol. 2015 Aug:69:156-64. doi: 10.1016/j.jcv.2015.06.091. Epub 2015 Jun 23.

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.

Keywords: Nervous system diseases; Neuralgic amyotrophy; Parsonage turner syndrome; Strong hepatitis E.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Brachial Plexus Neuritis / diagnosis
  • Brachial Plexus Neuritis / epidemiology*
  • Brachial Plexus Neuritis / virology*
  • Developed Countries
  • Female
  • Hepatitis E / blood
  • Hepatitis E / complications*
  • Hepatitis E / epidemiology*
  • Humans
  • Immunoglobulin M / blood
  • Male
  • Middle Aged
  • Sex Factors

Substances

  • Immunoglobulin M