title: Hepatitis E and neuralgic amyotrophy: Five cases and review of literature.
abstract: Hepatitis E virus infection - mainly genotype 3 - is increasingly common in industrialized countries. Infection is usually asymptomatic, but cases of central or peripheral neurological symptoms with hepatitis E have been described. The most frequent is Guillain-Barre but somes cases of neuralgic amyotrophy have been described. In our center, since 2010, we have identified five cases of neuralgic amyotrophy associated with acute hepatitis E in immunocompetent patients. For all these patients, neuralgic amyotrophy was diagnosed with electromyogram and positive IgM for hepatitis E, and detectable HEV RNA in 4 of the cases. Including our patients, we count 26 cases in literature. The mean age of the patients was 44 years old, with a large predominance of males (88%). The disorder is bilateral and asymmetric in 69% of cases. Peripheral nerves other than the brachial plexus were affected in 6 patients (23%). In industrialized countries, any neuralgic amyotrophy, particularly if there is bilateral, asymmetric associated with involvement of nerves outside the brachial plexus, should lead physicians to consider a diagnosis of acute hepatitis E.
authors.affiliation: Internal Medicine Department, Grenoble University Hospital, France. Electronic address: adartevel@chu-grenoble.fr.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Dartevel
authors.affiliation: Internal Medicine Department, Grenoble University Hospital, France.
authors.forename: Barbara
authors.initials: B
authors.lastname: Colombe
authors.affiliation: Internal Medicine Department, Grenoble University Hospital, France.
authors.forename: Annick
authors.initials: A
authors.lastname: Bosseray
authors.affiliation: Virology Department, Reference Center of Neuromuscular Disease, Grenoble University Hospital, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Larrat
authors.affiliation: Internal Medicine Department, Grenoble University Hospital, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Sarrot-Reynauld
authors.affiliation: Internal Medicine Department, Grenoble University Hospital, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Belbezier
authors.affiliation: Neurology Department, Grenoble University Hospital, France.
authors.forename: Emmeline
authors.initials: E
authors.lastname: Lagrange
authors.affiliation: Internal Medicine Department, Grenoble University Hospital, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bouillet
mesh_terms: D000328:Adult; D020968:Brachial Plexus Neuritis / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D019049:Developed Countries; D005260:Female; D016751:Hepatitis E / Q000097:blood / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
chemical_list: D007075:Immunoglobulin M
keywords: Nervous system diseases; Neuralgic amyotrophy; Parsonage turner syndrome; Strong hepatitis E