title: Transverse myelitis caused by hepatitis E: previously undescribed in adults.
abstract: We report the case of a 62-year-old Caucasian woman who was admitted with urinary retention and lower limb paraesthesia following a week's prodromal illness of headache and malaise. Liver function tests showed a picture of acute hepatocellular dysfunction. She developed reduced lower limb power, brisk reflexes, extensor plantars, a sensory level at T8 and reduced anal sphincter tone, establishing a clinical diagnosis of transverse myelitis. A spinal MRI showed no evidence of cauda equina or spinal cord compression. Cerebrospinal fluid (CSF) analysis showed raised protein and raised white cell count. Hepatitis E IgM and IgG were positive and hepatitis E virus was found in her CSF. She was treated with methylprednisolone and is slowly recovering with physiotherapy.
authors.affiliation: Department of Neurology, Southmead Hospital, Bristol, UK.
authors.forename: Pamela
authors.initials: P
authors.lastname: Sarkar
authors.affiliation: Department of Neurology, Southmead Hospital, Bristol, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Morgan
authors.affiliation: Public Health England, London, UK.
authors.forename: Samreen
authors.initials: S
authors.lastname: Ijaz
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D005260:Female; D016751:Hepatitis E / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D035002:Lower Extremity; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009188:Myelitis, Transverse / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D010292:Paresthesia / Q000209:etiology* / Q000821:virology; D026741:Physical Therapy Modalities; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology* / Q000821:virology
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D008775:Methylprednisolone