Neurologic complications of acute hepatitis E virus infection.

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Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_7824310363C5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Neurologic complications of acute hepatitis E virus infection.
Journal
Neurology
Author(s)
Ripellino P., Pasi E., Melli G., Staedler C., Fraga M., Moradpour D., Sahli R., Aubert V., Martinetti G., Bihl F., Bernasconi E., Terziroli Beretta-Piccoli B., Cerny A., Dalton H.R., Zehnder C., Mathis B., Zecca C., Disanto G., Kaelin-Lang A., Gobbi C.
ISSN
2332-7812 (Electronic)
ISSN-L
2332-7812
Publication state
Published
Issued date
01/2020
Peer-reviewed
Oui
Volume
7
Number
1
Pages
e643
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
To assess the prevalence and clinical features of neurologic involvement in patients with acute hepatitis E virus (HEV) infection in Southern Switzerland.
Among 1,940 consecutive patients investigated for acute hepatitis E, we identified 141 cases of acute of HEV infection (anti-HEV immunoglobulin M and immunoglobulin G both reactive and/or HEV RNA positive) between June 2014 and September 2017. Neurologic cases were followed up for 6 months. We compared patients with and without neurologic symptoms.
Neurologic symptoms occurred in 43 acute HEV cases (30.4%) and consisted of neuralgic amyotrophy (NA, n = 15, 10.6%) and myalgia (n = 28, 19.8%). All NA cases were immunocompetent. Men had higher odds (OR = 5.2, CI 1.12-24.0, p = 0.03) of developing NA after infection with HEV, and in 3 couples simultaneously infected with HEV, only men developed NA. Bilateral involvement of NA was predominant (2:1) and occurred only in men. Seven NA cases were viremic (all genotype 3), but HEV was undetectable in their CSF. In the acute phase of NA, 9 patients were treated with intravenous immunoglobulin and 4 with prednisone, reporting no side effects and improvement in pain and strength. Myalgia occurred both without (n = 16) or with (n = 12) concomitant elevated serum creatinine kinase. Seven cases with myalgia in the shoulder girdle did not have muscle weakness ("forme fruste" of NA).
Neurologic symptoms occurred in one-third of acute HEV infections and consisted of NA and myalgia. NA seems to occur more frequently in men infected by HEV and has a predominant (but not exclusive) bilateral involvement.
Keywords
Acute Disease, Adult, Aged, Brachial Plexus Neuritis/epidemiology, Brachial Plexus Neuritis/etiology, Female, Follow-Up Studies, Hepatitis E/complications, Hepatitis E/epidemiology, Humans, Male, Middle Aged, Myalgia/epidemiology, Myalgia/etiology, Prevalence, Switzerland/epidemiology
Pubmed
Web of science
Open Access
Yes
Create date
15/12/2019 17:38
Last modification date
30/04/2021 6:11
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