HEPATITIS E VIRUS INFECTION AS A DIRECT CAUSE OF NEURALGIC AMYOTROPHY

被引:24
作者
Silva, Mauro [1 ]
Wicki, Benoit [1 ]
Tsouni, Pinelopi [1 ]
Cunningham, Sophie [2 ]
Doerig, Christopher [2 ]
Zanetti, Giorgio [3 ,4 ]
Aubert, Vincent [5 ]
Sahli, Roland [6 ]
Moradpour, Darius [2 ]
Kuntzer, Thierry [1 ]
机构
[1] Univ Hosp Lausanne CHUV, Dept Clin Neurosci, Serv Neurol, Rue Bugnon 46, CH-1011 Lausanne, Switzerland
[2] Univ Lausanne, Ctr Hosp Univ Vaudois, Serv Gastroenterol & Hepatol, Lausanne, Switzerland
[3] Univ Lausanne, Ctr Hosp Univ Vaudois, Infect Dis Serv, Lausanne, Switzerland
[4] Univ Lausanne, Ctr Hosp Univ Vaudois, Serv Hosp Prevent Med, Lausanne, Switzerland
[5] Univ Lausanne, Ctr Hosp Univ Vaudois, Serv Immunol & Allergy, Lausanne, Switzerland
[6] Univ Lausanne, Ctr Hosp Univ Vaudois, Inst Microbiol, Lausanne, Switzerland
关键词
acute cervical radiculoplexopathy; anti-HEV antibody; HEV RNA; intravenous immunoglobulins; neuralgic amyotrophy; PATIENT;
D O I
10.1002/mus.25096
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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.
引用
收藏
页码:325 / 327
页数:3
相关论文
共 11 条
[11]   Neuralgic amyotrophy and hepatitis E virus infection [J].
van Eijk, Jeroen J. J. ;
Madden, Richie G. ;
van der Eijk, Annemiek A. ;
Hunter, Jeremy G. ;
Reimerink, Johan H. J. ;
Bendall, Richard P. ;
Pas, Suzan D. ;
Ellis, Vic ;
van Alfen, Nens ;
Beynon, Laura ;
Southwell, Lucy ;
McLean, Brendan ;
Jacobs, Bart C. ;
van Engelen, Baziel G. M. ;
Dalton, Harry R. .
NEUROLOGY, 2014, 82 (06) :498-503