Acute hepatitis E infection associated with Guillain-Barré syndrome in an immunocompetent patient

• Published in: La revue de medecine interne Vol. 35; no. 5; pp. 333 - 336
• Main Authors: Comont, T, Bonnet, D, Sigur, N, Gerdelat, A, Legrand-Abravanel, F, Kamar, N, Alric, L
• Format: Journal Article
• Language: French
• Published: France 01-05-2014
• Subjects: Acute Disease; Aged; Guillain-Barre Syndrome - complications; Guillain-Barre Syndrome - diagnosis; Guillain-Barre Syndrome - immunology; Hepatitis E - complications; Hepatitis E - diagnosis; Hepatitis E - immunology; Humans; Immunocompetence; Male; Hepatitis; Hépatite; Polyradiculopathy; Antiganglioside antibodies; Intravenous immunoglobulin; Syndrome de Guillain-Barré; Virus de l’hépatite E; Anticorps antigangliosides; Polyradiculonévrite; Guillain-Barré syndrome; Hepatitis E virus; Immunoglobulines intraveineuses
• ISSN: 1768-3122
• DOI: 10.1016/j.revmed.2013.05.005

Hepatitis E virus (HEV) infection is now recognized to be an emerging autochthonous disease in several countries. There have been several reports of neurological manifestations associated with HEV infections. Immunocompromised patients seem to be particularly vulnerable.
We report a 73-year-old man who presented with an acute polyradiculopathy and an acute hepatitis. HEV RNA was positive in serum and cerebrospinal fluid. Serum antiganglioside antibodies were also detected. Liver function tests returned to normal rapidly and HEV RNA was undetectable 4 weeks after initial testing. The neurological features improved gradually with the use of intravenous immunoglobulins.
We report a case of Guillain-Barré syndrome related to acute hepatitis E in an immunocompetent patient. The outcome was favorable after intravenous immunoglobulins administration. HEV screening should be systematic in patients who present with an acute polyradiculopathy and abnormal liver function tests.