Hepatitis E-Associated Lower Extremity Weakness: Case Report and Review of Literature

Abstract

Hepatitis E virus (HEV) infection is a well-known cause of acute hepatitis in developing countries. However, autochthonous (locally acquired) HEV infection is also emerging in industrialized countries. Neurologic signs and symptoms are an emerging extrahepatic manifestation of HEV infection. An association between neurologic manifestations (e.g., Guillain-Barre syndrome, neuralgic amyotrophy, and acute transverse myelitis) and acute HEV infection has been suggested. We present a case of a 26-year-old Hispanic female who presented with lower extremity weakness and elevated liver enzymes who was found to be positive for hepatitis E IgM antibodies. We recommend that clinicians strongly consider the possibility of HEV infection in patients with neurologic disorders, especially those with peripheral nerve involvement and liver abnormalities indicated by blood tests. Patients with unexplained hepatitis should be tested for hepatitis E, whatever their age or travel history.




J Med Cases. 2015;6(1):6-7
doi: http://dx.doi.org/10.14740/jmc1843w