Neurological Manifestations of HEV Infection: A Rare Phenomenon or an Underrecognized Reality?
ABSTRACT Aim This study aimed to describe neurological manifestations secondary to hepatitis E virus (HEV) through the description of two clinical cases. Methods Two different cases of neuralgic amyotrophy and meningoradiculitis are evaluated in the emergency department of a tertiary referral hospit...
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Wiley
2025-06-01
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| Series: | Brain and Behavior |
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| Online Access: | https://doi.org/10.1002/brb3.70585 |
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| author | Maider Iza Daniel Ramos Arnau Llauradó Juan Luis Restrepo‐Vera Mercedes Pallero Galo Granados Jose Alemany Javier Sotoca Júlia Sampol Sergi Martí Daniel Sanchez‐Tejerina Maria Salvadó Raul Juntas |
| author_facet | Maider Iza Daniel Ramos Arnau Llauradó Juan Luis Restrepo‐Vera Mercedes Pallero Galo Granados Jose Alemany Javier Sotoca Júlia Sampol Sergi Martí Daniel Sanchez‐Tejerina Maria Salvadó Raul Juntas |
| author_sort | Maider Iza |
| collection | DOAJ |
| description | ABSTRACT Aim This study aimed to describe neurological manifestations secondary to hepatitis E virus (HEV) through the description of two clinical cases. Methods Two different cases of neuralgic amyotrophy and meningoradiculitis are evaluated in the emergency department of a tertiary referral hospital in 2024. Results Case 1: A 43‐year‐old male presented to the emergency department with proximal weakness and pain in the right upper extremity associated with acute onset of orthopnea. Laboratory tests revealed elevated AST/ALT levels (184/1164 IU/L) and positive HEV IgM and IgG, with detectable serum HEV viral load. Cerebrospinal fluid (CSF) was negative for HEV RNA. A significant decrease in forced vital capacity was observed on transition from the upright to the supine position. Electromyography showed severe bilateral phrenic nerve involvement. The diagnosis of neuralgic amyotrophy with diaphragmatic paralysis secondary to HEV was made. The patient was treated with intravenous immunoglobulins and noninvasive ventilation with partial improvement. Case 2: A 37‐year‐old male presented to the emergency department with paresthesias and weakness, initially affecting the distal upper and lower extremities and progressing proximally. Laboratory tests showed elevated AST/ALT levels (238/626 IU/L), positive HEV IgM and IgG, and a detectable HEV viral load in serum. HEV RNA was also detected in the CSF. Neurophysiological findings were normal. The patient was diagnosed with acute meningoradiculitis secondary to HEV. Treatment with intravenous immunoglobulins led to complete resolution of symptoms. Conclusions In cases of acute neurological symptoms and liver dysfunction, HEV should be considered as a potential causative agent. |
| format | Article |
| id | doaj-art-adc243d3954d4af4baa5fd40014e5880 |
| institution | Kabale University |
| issn | 2162-3279 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj-art-adc243d3954d4af4baa5fd40014e58802025-08-20T03:36:38ZengWileyBrain and Behavior2162-32792025-06-01156n/an/a10.1002/brb3.70585Neurological Manifestations of HEV Infection: A Rare Phenomenon or an Underrecognized Reality?Maider Iza0Daniel Ramos1Arnau Llauradó2Juan Luis Restrepo‐Vera3Mercedes Pallero4Galo Granados5Jose Alemany6Javier Sotoca7Júlia Sampol8Sergi Martí9Daniel Sanchez‐Tejerina10Maria Salvadó11Raul Juntas12Neurology Department Vall d´Hebron University Hospital Barcelona SpainPneumology Department Vall d´Hebron University Hospital Barcelona SpainNeurology Department Vall d´Hebron University Hospital Barcelona SpainNeurology Department Vall d´Hebron University Hospital Barcelona SpainPneumology Department Vall d´Hebron University Hospital Barcelona SpainPneumology Department Vall d´Hebron University Hospital Barcelona SpainNeurology Department Vall d´Hebron University Hospital Barcelona SpainNeurology Department Vall d´Hebron University Hospital Barcelona SpainPneumology Department Vall d´Hebron University Hospital Barcelona SpainPneumology Department Vall d´Hebron University Hospital Barcelona SpainNeurology Department Vall d´Hebron University Hospital Barcelona SpainNeurology Department Vall d´Hebron University Hospital Barcelona SpainNeurology Department Vall d´Hebron University Hospital Barcelona SpainABSTRACT Aim This study aimed to describe neurological manifestations secondary to hepatitis E virus (HEV) through the description of two clinical cases. Methods Two different cases of neuralgic amyotrophy and meningoradiculitis are evaluated in the emergency department of a tertiary referral hospital in 2024. Results Case 1: A 43‐year‐old male presented to the emergency department with proximal weakness and pain in the right upper extremity associated with acute onset of orthopnea. Laboratory tests revealed elevated AST/ALT levels (184/1164 IU/L) and positive HEV IgM and IgG, with detectable serum HEV viral load. Cerebrospinal fluid (CSF) was negative for HEV RNA. A significant decrease in forced vital capacity was observed on transition from the upright to the supine position. Electromyography showed severe bilateral phrenic nerve involvement. The diagnosis of neuralgic amyotrophy with diaphragmatic paralysis secondary to HEV was made. The patient was treated with intravenous immunoglobulins and noninvasive ventilation with partial improvement. Case 2: A 37‐year‐old male presented to the emergency department with paresthesias and weakness, initially affecting the distal upper and lower extremities and progressing proximally. Laboratory tests showed elevated AST/ALT levels (238/626 IU/L), positive HEV IgM and IgG, and a detectable HEV viral load in serum. HEV RNA was also detected in the CSF. Neurophysiological findings were normal. The patient was diagnosed with acute meningoradiculitis secondary to HEV. Treatment with intravenous immunoglobulins led to complete resolution of symptoms. Conclusions In cases of acute neurological symptoms and liver dysfunction, HEV should be considered as a potential causative agent.https://doi.org/10.1002/brb3.70585hepatitis E virusimmunoglobulinsmeningoradiculitisneuralgic amyotrophyneurologic manifestations |
| spellingShingle | Maider Iza Daniel Ramos Arnau Llauradó Juan Luis Restrepo‐Vera Mercedes Pallero Galo Granados Jose Alemany Javier Sotoca Júlia Sampol Sergi Martí Daniel Sanchez‐Tejerina Maria Salvadó Raul Juntas Neurological Manifestations of HEV Infection: A Rare Phenomenon or an Underrecognized Reality? Brain and Behavior hepatitis E virus immunoglobulins meningoradiculitis neuralgic amyotrophy neurologic manifestations |
| title | Neurological Manifestations of HEV Infection: A Rare Phenomenon or an Underrecognized Reality? |
| title_full | Neurological Manifestations of HEV Infection: A Rare Phenomenon or an Underrecognized Reality? |
| title_fullStr | Neurological Manifestations of HEV Infection: A Rare Phenomenon or an Underrecognized Reality? |
| title_full_unstemmed | Neurological Manifestations of HEV Infection: A Rare Phenomenon or an Underrecognized Reality? |
| title_short | Neurological Manifestations of HEV Infection: A Rare Phenomenon or an Underrecognized Reality? |
| title_sort | neurological manifestations of hev infection a rare phenomenon or an underrecognized reality |
| topic | hepatitis E virus immunoglobulins meningoradiculitis neuralgic amyotrophy neurologic manifestations |
| url | https://doi.org/10.1002/brb3.70585 |
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