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Hepatitis E-associated encephalopathy in a renal transplant recipient
Marijke A de Vries1, Johnny P A Samijn, Rob de Man
1Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands.
BMJ Case Reports
|May 3, 2014
Summary
Hepatitis E virus genotype 3 can cause chronic liver disease and severe neurological issues in transplant patients. Early diagnosis and treatment can resolve symptoms and reduce viral load.
Area of Science:
- Hepatology
- Virology
- Neurology
Background:
- Hepatitis E virus (HEV) genotype 3 is increasingly recognized in developed nations.
- HEV can lead to chronic hepatitis, particularly in immunocompromised individuals.
- Extrahepatic manifestations, including neurological complications, are significant concerns.
Observation:
- A renal transplant recipient presented with chronic HEV infection.
- Symptoms included encephalopathy, ataxia, Lhermitte's sign, bladder dysfunction, and neuropathy.
- Diagnosis was delayed for years after initial symptoms and months after neurological onset.
Findings:
- Chronic HEV genotype 3 infection was confirmed in the patient.
- The patient experienced a spectrum of severe neurological symptoms attributed to HEV.
- Treatment led to reduced viral load and resolution of neurological deficits in most cases.
Implications:
- Increased awareness of HEV and its neurological effects can expedite diagnosis.
- Prompt treatment can mitigate severe neurological sequelae.
- Pretransplant screening with serology and potential vaccination could prevent future infections.
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