ABSTRACT
INTRODUCTION: Hepatitis E is an emerging, worldwide disease. It is often asymptomatic. Nevertheless, in few cases, clinical manifestation such as neurological disorder could be present. The aim of this article is to realize a literature review of the neurological symptoms associated with hepatitis E. METHODS: We searched the Pubmed database using the term "hepatitis E", "neurological disorder AND hepatitis E". RESULTS: One hundred and thirty cases have been described between 2000 and 2017. The majority of cases were associated with the genotype 3 and were reported in Europe or in Asia. It preferentially affected immunocompetent (93%) men with a median age of 52 years. The main neurologic disorders were Guillain-Barré syndrome (54 cases), Parsonage-Turner syndrome (35 cases), multiplex mononeuropathy (6 cases), meningitis and meningoencephalitis (9 cases). The diagnosis was done with HEV IgM serology in most cases (98%). Aminotranferases increase and cholestasis were found in 88% and 82% respectively. The outcome varied according to the neurological syndrome. Antiviral or immunomodulatory therapies did not seem to improve symptoms. CONCLUSION: Hepatitis E seems to be associated with acute, wide neurological disorders. These data should be confirmed with a long term prospective study.
Subject(s)
Hepatitis E/complications , Nervous System Diseases/etiology , Acute Disease , Brachial Plexus Neuritis/diagnosis , Brachial Plexus Neuritis/virology , Disease Progression , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/virology , Hepatitis E/diagnosis , Hepatitis E/epidemiology , Hepatitis E/pathology , Humans , Nervous System Diseases/diagnosis , Nervous System Diseases/epidemiology , Nervous System Diseases/pathologyABSTRACT
Hepatitis E (HEV) is an emerging disease in our developed countries, but is not routinely tested for in case of liver cytolysis. However, a growing number of extra-hepatic manifestations of HEV infection associated with acute hepatitis are reported. In this article, we discuss two cases of HEV with neurological symptoms, one with encephalitis, and the other with Parsonage Turner syndrome. All these disorders appeared concomitantly with liver cytolysis and disappeared quickly, following the viral kinetics. Only twenty cases of neurological manifestation of HEV have been described before. The use of HEV serology in patients with concurrent liver cytolysis and neurological symptoms has to be improved.
