Abstract
Neurologic disorders, mainly Guillain-Barré syndrome and Parsonage–Turner syndrome (PTS), have been described in patients with hepatitis E virus (HEV) infection in industrialized and developing countries. We report a wider range of neurologic disorders in nonimmunocompromised patients with acute HEV infection. Data from 15 French immunocompetent patients with acute HEV infection and neurologic disorders were retrospectively recorded from January 2006 through June 2013. The disorders could be divided into 4 main entities: mononeuritis multiplex, PTS, meningoradiculitis, and acute demyelinating neuropathy. HEV infection was treated with ribavirin in 3 patients (for PTS or mononeuritis multiplex). One patient was treated with corticosteroids (for mononeuropathy multiplex), and 5 others received intravenous immunoglobulin (for PTS, meningoradiculitis, Guillain-Barré syndrome, or Miller Fisher syndrome). We conclude that pleiotropic neurologic disorders are seen in HEV-infected immunocompetent patients. Patients with acute neurologic manifestations and aminotransferase abnormalities should be screened for HEV infection.
Highlights
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Emerging Infectious Diseases
Data were recorded from patients with neurologic disorders, regardless of the symptoms exhibited during the course of acute hepatitis E virus (HEV) infection
Because the study was retrospective, it was not possible to identify the prevalence of HEV infection in patients with neurologic symptoms or the prevalence of neurologic symptoms in patients with HEV infection
Summary
Neurologic disorders, mainly Guillain-Barré syndrome and Parsonage–Turner syndrome (PTS), have been described in patients with hepatitis E virus (HEV) infection in industrialized and developing countries. We report a wider range of neurologic disorders in nonimmunocompromised patients with acute HEV infection. Hepatitis E virus (HEV) infection is an emerging autochthonous disease in industrialized countries [1]. Cases describing neurologic involvement during acute HEV infection have been reported [6,7]: most concerned Guillain-Barré syndrome (GBS) and ParsonageTurner syndrome (PTS). Studies of 2 national cohorts (in the United Kingdom and the Netherlands) have found that GBS and PTS were associated with acute HEV infection in 5% and 10% of cases, respectively [11,12]. We describe an additional range of neurologic manifestations that were found during acute autochthonous HEV infection in immunocompetent patients
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