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Neuralgic amyotrophy and hepatitis E virus infection.
[neuralgic amyotrophy]
To
determine
whether
there
is
an
association
between
an
acute
preceding
hepatitis
E
virus
(
HEV
)
infection
and
neuralgic
amyotrophy
(
NA
)
,
and
if
so
,
whether
patients
with
HEV-related
NA
differ
from
patients
without
an
associated
HEV
infection
.
HEV
testing
was
conducted
in
a
retrospective
cohort
of
28
Cornish
patients
with
NA
(
2011
-
2013
)
and
a
prospective
cohort
of
38
consecutive
Dutch
patients
with
NA
(
2004
-
2007
)
.
Acute
-phase
serum
samples
were
analyzed
for
the
presence
of
anti-
HEV
immunoglobulin
(
Ig
)
M
and
IgG
and
HEV
RNA
(
quantitative
real-time
PCR
)
.
Five
cases
(
10
.
6
%
)
of
acute
hepatitis
E
infection
were
identified
in
a
total
group
of
47
patients
with
NA
of
whom
serum
samples
were
available
.
In
4
patients
,
HEV
RNA
was
detected
in
serum
samples
taken
at
presentation
.
All
patients
with
HEV-associated
NA
had
clinical
and
electrophysiologic
evidence
of
bilateral
brachial
plexus
involvement
.
Anti-
HEV
IgM
positivity
was
not
related
to
age
,
sex
,
disease
severity
,
disease
course
,
or
outcome
.
Acute
hepatitis
E
is
found
in
10
%
of
patients
with
NA
from
the
United
Kingdom
and
the
Netherlands
.
Further
research
is
required
to
investigate
the
role
of
HEV
in
NA
in
other
geographical
locations
and
to
determine
pathophysiologic
mechanisms
.
