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Neuralgic amyotrophy triggered by hepatitis E virus: a particular phenotype
Quentin Scanvion1, Thierry Perez2, François Cassim3
1Internal Medicine Department, National Reference Center for Rare Autoimmune Systemic Diseases, FHU IMMINeNT, Medical School Henri Warembourg, Lille University Hospital, 59000, Lille, France. quentin.scanvion@gmail.com.
Journal of Neurology
|March 2, 2017
Summary
Hepatitis E virus-neuralgic amyotrophy (HEV-NA) presents uniquely, often affecting men bilaterally with phrenic nerve involvement. Early diagnosis of HEV-NA is crucial for better outcomes, as recovery is often limited.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Medicine
Background:
- Neuralgic amyotrophy (NA) diagnosis is challenging due to varied presentations.
- Limited guidance exists for managing NA, particularly when triggered by Hepatitis E virus (HEV-NA).
- Identifying specific features of HEV-NA is essential for timely diagnosis and management.
Observation:
- A case of HEV-NA with delayed diaphragmatic involvement is presented.
- Literature review identified 39 HEV-NA cases and 42 NA cases with phrenic paresis (1999-2016).
- HEV-NA patients were compared to a cohort of 199 idiopathic NA cases.
Findings:
- HEV-NA predominantly affects men (p=0.017) and frequently presents with bilateral symptoms (86.8%, p<0.0001).
- Phrenic paresis is significantly more common in HEV-NA (18.0%, p=0.028) compared to idiopathic NA.
- Clinical improvement in HEV-NA is generally poor, with only 15.6% achieving remission.
Implications:
- A distinct phenotype for HEV-induced NA has been identified.
- These findings necessitate validation to facilitate early HEV-NA diagnosis.
- Early diagnosis can prevent complications, especially phrenic damage, improving functional outcomes.
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