[Acute disseminated encephalomyelitis associated with hepatitis A virus infection].
BACKGROUND
Hepatitis virus A (HVA) infection is usually a benign infection, but it can lead to severe manifestations and neurological symptoms.


METHODS
We report the case of a 44-year-old man who was admitted for pyramidal tetraparesis, loss of proprioceptive sensitivity and cranial nerve involvement. He had developed concomitally jaundice and fatigue. Brain MRI and cerebrospinal fluid examination were normal. Blood tests revealed elevated serum transaminase and anti-hepatitis A virus (IgM and IgG) levels. Acute disseminated encephalomyelitis (ADEM) was diagnosed and the patient was treated with high dose intravenous then oral corticosteroid therapy. The clinical condition continued to deteriorate and the patient died at eight months.


CONCLUSIONS
ADEM is exceptionally associated with HVA infection or after vaccination for hepatitis A. Other neurological complications, including either peripheral or central nervous system, are reported. The clinical presentation and the outcome of our patient are atypical.
El Moutawakil
B
B
Service de neurologie-explorations fonctionnelles, CHU Ibn Rochd, Casablanca, Maroc. elmoutawakilb@yahoo.fr
Bourezgui
M
M
Rafai
M A
MA
Sibai
M
M
Boulaajaj
F Z
FZ
Moutaouakil
F
F
Otmani
H
H
Slassi
I
I
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003389:Cranial Nerve Diseases / Q000209:etiology; D004673:Encephalomyelitis, Acute Disseminated / Q000134:cerebrospinal fluid / Q000150:complications*; D017809:Fatal Outcome; D006506:Hepatitis A / Q000134:cerebrospinal fluid / Q000150:complications*; D035922:Hepatitis A Antibodies / Q000032:analysis; D006801:Humans; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D011434:Proprioception / Q000502:physiology; D011782:Quadriplegia / Q000209:etiology
D000893:Anti-Inflammatory Agents; D035922:Hepatitis A Antibodies; D008775:Methylprednisolone