Titre
Clinical phenotype and outcome of hepatitis E virus-associated neuralgic amyotrophy.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
van Eijk, JJJ
Auteure/Auteur
Dalton, H.R.
Auteure/Auteur
Ripellino, P.
Auteure/Auteur
Madden, R.G.
Auteure/Auteur
Jones, C.
Auteure/Auteur
Fritz, M.
Auteure/Auteur
Gobbi, C.
Auteure/Auteur
Melli, G.
Auteure/Auteur
Pasi, E.
Auteure/Auteur
Herrod, J.
Auteure/Auteur
Lissmann, R.F.
Auteure/Auteur
Ashraf, H.H.
Auteure/Auteur
Abdelrahim, M.
Auteure/Auteur
Masri, OABAL
Auteure/Auteur
Fraga, M.
Auteure/Auteur
Benninger, D.
Auteure/Auteur
Kuntzer, T.
Auteure/Auteur
Aubert, V.
Auteure/Auteur
Sahli, R.
Auteure/Auteur
Moradpour, D.
Auteure/Auteur
Blasco-Perrin, H.
Auteure/Auteur
Attarian, S.
Auteure/Auteur
Gérolami, R.
Auteure/Auteur
Colson, P.
Auteure/Auteur
Giordani, M.T.
Auteure/Auteur
Hartl, J.
Auteure/Auteur
Pischke, S.
Auteure/Auteur
Lin, N.X.
Auteure/Auteur
Mclean, B.N.
Auteure/Auteur
Bendall, R.P.
Auteure/Auteur
Panning, M.
Auteure/Auteur
Peron, J.M.
Auteure/Auteur
Kamar, N.
Auteure/Auteur
Izopet, J.
Auteure/Auteur
Jacobs, B.C.
Auteure/Auteur
van Alfen, N.
Auteure/Auteur
van Engelen, BGM
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1526-632X
Statut éditorial
Publié
Date de publication
2017-08-29
Volume
89
Numéro
9
Première page
909
Dernière page/numéro d’article
917
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
To determine the clinical phenotype and outcome in hepatitis E virus-associated neuralgic amyotrophy (HEV-NA).
Cases of NA were identified in 11 centers from 7 European countries, with retrospective analysis of demographics, clinical/laboratory findings, and treatment and outcome. Cases of HEV-NA were compared with NA cases without evidence of HEV infection.
Fifty-seven cases of HEV-NA and 61 NA cases without HEV were studied. Fifty-six of 57 HEV-NA cases were anti-HEV IgM positive; 53/57 were IgG positive. In 38 cases, HEV RNA was recovered from the serum and in 1 from the CSF (all genotype 3). Fifty-one of 57 HEV-NA cases were anicteric; median alanine aminotransferase 259 IU/L (range 12-2,961 IU/L); in 6 cases, liver function tests were normal. HEV-NA cases were more likely to have bilateral involvement (80.0% vs 8.6%, <i>p</i> < 0.001), damage outside the brachial plexus (58.5% vs 10.5%, <i>p</i> < 0.01), including phrenic nerve and lumbosacral plexus injury (25.0% vs 3.5%, <i>p</i> = 0.01, and 26.4% vs 7.0%, <i>p</i> = 0.001), reduced reflexes ( <i>p</i> = 0.03), sensory symptoms ( <i>p</i> = 0.04) with more extensive damage to the brachial plexus. There was no difference in outcome between the 2 groups at 12 months.
Patients with HEV-NA are usually anicteric and have a distinct clinical phenotype, with predominately bilateral asymmetrical involvement of, and more extensive damage to, the brachial plexus. Involvement outside the brachial plexus is more common in HEV-NA. The relationship between HEV and NA is likely to be causal, but is easily overlooked. Patients presenting with NA should be tested for HEV, irrespective of liver function test results. Prospective treatment/outcome studies of HEV-NA are warranted.
Cases of NA were identified in 11 centers from 7 European countries, with retrospective analysis of demographics, clinical/laboratory findings, and treatment and outcome. Cases of HEV-NA were compared with NA cases without evidence of HEV infection.
Fifty-seven cases of HEV-NA and 61 NA cases without HEV were studied. Fifty-six of 57 HEV-NA cases were anti-HEV IgM positive; 53/57 were IgG positive. In 38 cases, HEV RNA was recovered from the serum and in 1 from the CSF (all genotype 3). Fifty-one of 57 HEV-NA cases were anicteric; median alanine aminotransferase 259 IU/L (range 12-2,961 IU/L); in 6 cases, liver function tests were normal. HEV-NA cases were more likely to have bilateral involvement (80.0% vs 8.6%, <i>p</i> < 0.001), damage outside the brachial plexus (58.5% vs 10.5%, <i>p</i> < 0.01), including phrenic nerve and lumbosacral plexus injury (25.0% vs 3.5%, <i>p</i> = 0.01, and 26.4% vs 7.0%, <i>p</i> = 0.001), reduced reflexes ( <i>p</i> = 0.03), sensory symptoms ( <i>p</i> = 0.04) with more extensive damage to the brachial plexus. There was no difference in outcome between the 2 groups at 12 months.
Patients with HEV-NA are usually anicteric and have a distinct clinical phenotype, with predominately bilateral asymmetrical involvement of, and more extensive damage to, the brachial plexus. Involvement outside the brachial plexus is more common in HEV-NA. The relationship between HEV and NA is likely to be causal, but is easily overlooked. Patients presenting with NA should be tested for HEV, irrespective of liver function test results. Prospective treatment/outcome studies of HEV-NA are warranted.
Sujets
PID Serval
serval:BIB_C9B115AF8AF3
PMID
Date de création
2018-07-11T06:33:55.621Z
Date de création dans IRIS
2025-05-21T04:34:56Z