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01.12.2018 | Case report | Ausgabe 1/2018 Open Access

BMC Infectious Diseases 1/2018

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

Zeitschrift:
BMC Infectious Diseases > Ausgabe 1/2018
Autoren:
Xiaoqin Zheng, Liang Yu, Qiaomai Xu, Silan Gu, Lingling Tang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12879-018-2959-2) contains supplementary material, which is available to authorized users.

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.
Zusatzmaterial
Additional file 1: Table S1. Liver function after admission in our hospital. The patient’s liver function tests showed showed 20 μmol/L total bilirubin, 10 μmol/L conjugated bilirubin, 126 U/L alanine aminotransferase, and 160 U/L gamma-glutamyl transpepidase. (DOCX 16 kb)
12879_2018_2959_MOESM1_ESM.docx
Additional file 2: Table S2. Serologic studies for hepatitis virus. Serologic studies for IgM and IgG anti-HEV were both positive. No serological evidence was found for hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus. (DOCX 15 kb)
12879_2018_2959_MOESM2_ESM.docx
Additional file 3: Table S3. Serological study for HBV, HCV, Syphilis and HIV. Serologic studies for hepatitis B virus, hepatitis C virus, syphilis or human immunodeficiency virus was negative. (DOCX 15 kb)
12879_2018_2959_MOESM3_ESM.docx
Additional file 4: Table S4. Serological study for Epstein–Barr virus and cytomegalovirus. Epstein–Barr virus and cytomegalovirus serology indicated positive IgG. (DOCX 14 kb)
12879_2018_2959_MOESM4_ESM.docx
Additional file 5: Table S5. The first cerebrospinal fluid (CSF) examination. Cerebrospinal fluid (CSF) examination showed 0/μL monocyte, 4.6 mmol/L glucose level, and 275.3 mg/dL protein level. (DOCX 15 kb)
12879_2018_2959_MOESM5_ESM.docx
Additional file 6: Table S6. The second cerebrospinal fluid (CSF) examination. Cerebrospinal fluid (CSF) examination revealed 10/μL monocyte and 85.7 mg/dL protein level. (DOCX 15 kb)
12879_2018_2959_MOESM6_ESM.docx
Additional file 7: Table S7. Liver function (one month later after discharge). A month later, the liver function of the patient substantially improved, and his serum levels of AST and ALT were nearly normal. (DOCX 16 kb)
12879_2018_2959_MOESM7_ESM.docx
Additional file 8: Table S8. Serological study for HEV(six months later). Six months after discharge, serological study showed IgM anti-HEV antibodies became negative. (DOCX 15 kb)
12879_2018_2959_MOESM8_ESM.docx
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