Neuralgic amyotrophy and hepatitis E virus infection

作者：van Eijk Jeroen J J; Madden Richie G; van der Eijk Annemiek A; Hunter Jeremy G; Reimerink Johan H J; Bendall Richard P; Pas Suzan D; Ellis Vic; van Alfen Nens; Beynon Laura; Southwell Lucy; McLean Brendan; Jacobs Bart C; van Engelen Baziel G M; Dalton Harry R^*

来源：Neurology, 2014, 82(6): 498-503.

DOI：10.1212/WNL.0000000000000112

Objective:To determine whether there is an association between an acute preceding hepatitis E virus (HEV) infection and neuralgic amyotrophy (NA), and if so, whether patients with HEV-related NA differ from patients without an associated HEV infection.Methods:HEV testing was conducted in a retrospective cohort of 28 Cornish patients with NA (2011-2013) and a prospective cohort of 38 consecutive Dutch patients with NA (2004-2007). Acute-phase serum samples were analyzed for the presence of anti-HEV immunoglobulin (Ig) M and IgG and HEV RNA (quantitative real-time PCR).Results:Five cases (10.6%) of acute hepatitis E infection were identified in a total group of 47 patients with NA of whom serum samples were available. In 4 patients, HEV RNA was detected in serum samples taken at presentation. All patients with HEV-associated NA had clinical and electrophysiologic evidence of bilateral brachial plexus involvement. Anti-HEV IgM positivity was not related to age, sex, disease severity, disease course, or outcome.Conclusions:Acute hepatitis E is found in 10% of patients with NA from the United Kingdom and the Netherlands. Further research is required to investigate the role of HEV in NA in other geographical locations and to determine pathophysiologic mechanisms.

• 出版日期2014-2-11