Case report: Hepatitis A preceding Guillain-Barré syndrome

Area of Science:

• * Infectious Diseases
• * Neurology
• * Virology

Background:

• * Hepatitis A virus (HAV) infection is typically an acute liver illness.
• * Guillain-Barré Syndrome (GBS) is an autoimmune disorder affecting peripheral nerves.
• * Neurological complications following viral infections are documented but rare for HAV.

Observation:

• * A 17-year-old male presented with acute Hepatitis A.
• * He subsequently developed Guillain-Barré Syndrome, specifically the acute motor axonal neuropathy (AMAN) subtype.
• * The onset of neurological symptoms occurred in the third week of illness.

Findings:

• * Serum and cerebrospinal fluid tested positive for anti-HAV IgM, IgG, and IgA antibodies.
• * Remarkably high titers of serum anti-HAV IgG were detected, a unique finding in a Hepatitis A patient with GBS.
• * Phylogenetic analysis identified the HAV strain as genotype IIIA, prevalent in western India.

Implications:

• * This case highlights a potential, albeit rare, neurological complication of Hepatitis A virus infection.
• * The presence of high anti-HAV IgG titers may warrant further investigation into immune responses in HAV-associated GBS.
• * Understanding the specific HAV genotype involved could aid in epidemiological tracking and understanding pathogen-host interactions.