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Published on: June 26, 2020
Neuralgic amyotrophy and hepatitis E virus infection.
Jeroen J J van Eijk1, Richie G Madden, Annemiek A van der Eijk
1From the Department of Neurology (J.J.J.v.E., N.v.A., B.G.M.v.E.), Radboud University Nijmegen Medical Centre; Department of Neurology (J.J.J.v.E.), Jeroen Bosch Hospital, Nijmegen, the Netherlands; Cornwall Gastrointestinal Unit (R.G.M., J.G.H., L.B., L.S., H.R.D.), Clinical Microbiology (R.P.B., V.E.), and Department of Neurology (B.M.), Royal Cornwall Hospital Trust; European Centre for the Environment and Human Health (R.G.M., J.G.H., R.P.B., L.B., H.R.D.), University of Exeter Medical School, Truro, UK; Centre for Infectious Disease Control (J.H.J.R.), Division Virology, National Institute for Public Health and the Environment, Bilthoven; Departments of Viroscience (A.A.v.d.E., S.D.P.), Immunology (B.C.J.), and Neurology (B.C.J.), Erasmus Medical Centre, University Medical Center Rotterdam, the Netherlands.
Acute hepatitis E infection precedes neuralgic amyotrophy in over 10% of cases. Patients with HEV-associated NA showed bilateral brachial plexus involvement, prompting further research into HEV
Area of Science:
- Neurology
- Infectious Diseases
- Hepatology
Background:
- Neuralgic amyotrophy (NA) is a rare neurological disorder.
- The association between acute hepatitis E virus (HEV) infection and NA is not well-established.
Purpose of the Study:
- To investigate the link between preceding acute HEV infection and NA.
- To compare clinical and electrophysiologic features of HEV-related NA versus non-HEV NA.
Main Methods:
- Retrospective and prospective cohorts of NA patients from the UK and Netherlands.
- HEV testing included anti-HEV IgM/IgG and HEV RNA (qRT-PCR) on acute-phase serum samples.
Main Results:
- 10.6% of NA patients (5/47) had evidence of acute HEV infection.
- HEV RNA was detected in 4 patients at presentation.
- HEV-associated NA cases demonstrated bilateral brachial plexus involvement.
Conclusions:
- Acute hepatitis E is identified in approximately 10% of NA patients in the UK and Netherlands.
- Further research is needed to explore HEV's role in NA globally and its mechanisms.
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