Hepatitis E and neuralgic amyotrophy: Five cases and review of literature

Dartevel, Anaïs; Colombe, B.; Bosseray, A.; Larrat, Sylvie; Sarrot-Reynauld, F.; Belbézier, Aude; Lagrange, É.; Bouillet, Laurence

doi:10.1016/j.jcv.2015.06.091

Cited by 40 publications

(33 citation statements)

References 34 publications

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“…The immune hypothesis is supported by the fact that half of affected patients report antecedent events that trigger the immune system, mostly infections, but also surgery, childbirth, and physical or mental strain . One recent report showed that about 10% of NA patients in the acute phase have a concomitant hepatitis E virus (HEV) infection, but many other types of infection preceding or accompanying the onset of NA have been reported . Although the peripheral nerves of the brachial plexus, which are the supposed localization of the autoimmune target in NA, are not easily accessed for direct examination, a few peripheral nerve biopsies have been reported from patients in the (sub)acute stage of NA .…”

Section: Pathophysiologymentioning

confidence: 99%

“…4 One recent report showed that about 10% of NA patients in the acute phase have a concomitant hepatitis E virus (HEV) infection, but many other types of infection preceding or accompanying the onset of NA have been reported. [32][33][34] Although the peripheral nerves of the brachial plexus, which are the supposed localization of the autoimmune target in NA, are not easily accessed for direct examination, a few peripheral nerve biopsies have been reported from patients in the (sub)acute stage of NA. 35,36 These biopsies of brachial plexus fascicles or the superficial radial nerve showed epineural perivascular mononuclear T-cell infiltration, active multifocal axonal degeneration without vessel wall inflammation or necrosis, and perineural thickening, whereas sural nerve examination in the chronic phase and a single postmortem study of the brachial plexus only identified evidence for axonal loss at a single fascicle level and no signs of vasculitis.…”

Section: Pathophysiologymentioning

confidence: 99%

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Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment

Groothuis²,

2016

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In this review we provide a current overview of the clinical features, pathophysiology, epidemiology, and diagnostic and therapeutic strategies in neuralgic amyotrophy (NA). The disorder has several phenotypic variations, with a classic form in 70% of the patients. It is not rare, with an incidence of 1 per 1,000 individuals, but it is still often missed. Recurrences are common, yet the proposed multifactorial etiology, which includes genetic, biomechanical, and immunologic factors, limits our capacity to predict or prevent them. NA is a clinical diagnosis, and ancillary studies serve to exclude infectious or malignant causes or to assess a differential diagnosis. If patients are seen early and are still in pain, a short trial of high-dose oral corticosteroids is advised, and adequate analgesia may require opioids and non-steroidal anti-inflammatory drugs. Persistent complaints are common, and a multidisciplinary rehabilitation approach focusing on scapular coordination, energy distribution strategies, and self-management is indicated.

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Section: Pathophysiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment

Groothuis²,

2016

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“…Por otro lado, no se ha demostrado vulnerabilidad inmunológica, pero la mitad de los afectados han sido expuestos a distintas noxas inmunológicas: infecciones, cirugía, parto y estrés físico o mental 11 . Existen reportes de NA asociado a virus de la hepatitis E (VHE) 12 , Bartonella henselae 13 , Borrelia burgdorferi e incluso a virus de la inmunodeficiencia humana (VIH). Pese a lo anterior, la hipótesis de un origen inmunome- diado se apoya en hallazgos histopatológicos de infiltrado perineural de linfocitos T y macrófagos, sin hallazgos de inflamación perivascular 14 .…”

Section: Discussionunclassified

Síndrome de Parsonage-Turner en paciente sometido a cirugía de revascularización miocárdica. Caso clínico

et al. 2019

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We report a 59-year-old male who, three weeks after a coronary revascularization surgery, reported a sudden intense burning pain in his left upper limb. Two weeks later, he reports a paresis with difficulty to extend his left wrist and fingers. The electromyography showed a severe axonal damage of the radial nerve with distal denervation signs. This clinical picture probably corresponds to a neuralgic amyotrophy, an inflammatory disorder of the brachial plexus known by a number of terms, including Parsonage-Turner syndrome.

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“…The prevalence of HEV infection in patients with neuralgic amyotrophy is 10% . In these cases, motor weakness and sensory disturbances are more often bilateral, asymmetric and are not confined to the brachial plexus compared to non HEV‐infected patients . The prevalence of HEV infection in patients with GBS is 5%…”

Section: Neurological Injurymentioning

confidence: 99%

“…18 In these cases, motor weakness and sensory disturbances are more often bilateral, asymmetric and are not confined to the brachial plexus compared to non HEV-infected patients. 19,20 The prevalence of HEV infection in patients with GBS is 5%. 21 The mechanisms by which HEV causes PTS or GBS are unknown, but it is probably an immune response induced by the virus.…”

Section: Neurolog I C Al Inj Urymentioning

confidence: 99%

Hepatitis E, what’s the real issue?

Larrue

Abravanel

Péron

2020

Liver International

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Hepatitis E Virus (HEV) infection is a worldwide disease and the primary cause of acute viral hepatitis in the world with an estimated 20 million cases every year and 70 000 deaths. Hepatitis E is a waterborne infection in the developing countries. In these countries, HEV genotypes 1 and 2 cause large outbreaks and affect young subjects, resulting in significant mortality in pregnant women and patients with cirrhosis. In the developed countries, HEV genotypes 3 and 4 are responsible for autochthonous, sporadic hepatitis and transmission is zoonotic. Parenteral transmission by the transfusion of blood products has been identified as a potential new mode of transmission. The prevalence of positive HEV viraemia in blood donors in Europe ranges from 1/600 to 1/2500 in highly endemic European countries. HEV can cause neurological disorders and chronic infections in immunocompromised patients. The progression of acute hepatitis E is usually asymptomatic and resolves spontaneously. Diagnostic tools include anti‐HEV IgM antibodies in serum and/or viral RNA detection in the blood or the stools by PCR. Ribavirin is used to treat chronic infection. A vaccine has been developed in China.

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Hepatitis E and neuralgic amyotrophy: Five cases and review of literature

Cited by 40 publications

References 34 publications

Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment

Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment

Síndrome de Parsonage-Turner en paciente sometido a cirugía de revascularización miocárdica. Caso clínico

Hepatitis E, what’s the real issue?

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