Guillain-Barre syndrome caused by hepatitis E infection: case report and literature review

BMC Infect Dis. 2018 Jan 23;18(1):50. doi: 10.1186/s12879-018-2959-2.

Abstract

Background: Hepatitis E infection is a global disorder that causes substantial morbidity. Numerous neurologic illnesses, including Guillain-Barre syndrome (GBS), have occurred in patients with hepatitis E virus (HEV) infection.

Case presentation: We report a 58 year-old non-immunocompromised man who presented with progressive muscle weakness in all extremities during an episode of acute HEV infection, which was confirmed by measuring the anti-HEV IgM antibodies in the serum. Both cerebrospinal fluid examination and electrophysiological study were in agreement with the diagnosis of HEV-associated GBS. Following the treatment with intravenous immunoglobulin, the patient's neurological condition improved rapidly.

Conclusions: HEV infection should be strongly considered in patients with neurological symptoms, especially those with elevated levels of liver enzymes.

Keywords: Extra-hepatic manifestations; Guillain–Barre syndrome; Hepatitis E infection; Viral hepatitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Guillain-Barre Syndrome / diagnosis*
  • Guillain-Barre Syndrome / etiology
  • Hepatitis Antibodies / blood
  • Hepatitis E / complications
  • Hepatitis E / diagnosis*
  • Hepatitis E / virology
  • Hepatitis E virus / immunology
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulins, Intravenous / therapeutic use
  • Male
  • Middle Aged
  • Monocytes / cytology

Substances

  • Hepatitis Antibodies
  • Immunoglobulin G
  • Immunoglobulins, Intravenous