Hepatitis E Virus-Associated Acute Encephalitic Parkinsonism.

Area of Science:

• Hepatology
• Neurology
• Infectious Diseases

Background:

• Hepatitis E virus (HEV) is a global pathogen with distinct epidemiological and clinical profiles in developed versus developing nations.
• Neurological complications are increasingly recognized as extrahepatic manifestations of both acute and chronic HEV infections.
• HEV is an emerging infectious disease in developed countries, necessitating a broader understanding of its clinical spectrum.

Observation:

• A 17-year-old athlete presented with acute encephalitic Parkinsonism coinciding with acute hepatitis.
• Diagnostic serology confirmed Hepatitis E virus (HEV) infection, and HEV RNA was detected.
• The patient experienced a full recovery with supportive and symptomatic management.

Findings:

• This case highlights a rare presentation of HEV-associated neurological disorder, specifically acute encephalitic Parkinsonism.
• Concurrent hepatitis and neurological symptoms in a young patient strongly suggested an infectious etiology.
• Confirmation of HEV infection via serology and RNA detection established the causative agent.

Implications:

• The findings suggest that HEV should be considered in the differential diagnosis of patients presenting with neurological disorders, particularly when accompanied by liver impairment.
• Diagnostic testing for HEV may be beneficial for patients with unexplained neurological conditions and concurrent liver dysfunction.
• This case underscores the importance of recognizing HEV's potential for diverse extrahepatic manifestations, including severe neurological syndromes.