Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of Guillain-Barré syndrome following hepatitis E virus infection

Monami Tarisawa, M.D.1), Ryo Ando, M.D.2), Katsuki Eguchi, M.D.1), Megumi Abe, M.D.1), Masaaki Matsushima, M.D., Ph.D.1) and Ichiro Yabe, M.D., Ph.D.1)

1) Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
2) Department of Gastroenterology, Teine Keijinkai Hospital

An 81-year-old man presented with limb weakness and dysesthesia approximately 10 days after eating pork liver. His neurological examination revealed muscle weakness predominantly centered in the lower limbs and absence of deep tendon reflex, and cerebrospinal fluid analysis showed elevated proteins with normal cell counts. Furthermore, his nerve conduction studies revealed distal motor latency prolongation and decreased motor nerve conduction velocities in the bilateral median, ulnar, tibial, and peroneal nerves. Lastly, serological analysis was performed for hepatitis E virus markers, resulting in a positive result for hepatitis E virus (HEV)-IgA antibody and HEV-RNA. Given all these findings, the patient was diagnosed with acute HEV-associated Guillain-Barré syndrome (GBS), and intravenous immunoglobulin treatment was administered for five days. Following this, muscle weakness and dysesthesia gradually improved. As observed in this report, the number of HEV-associated GBS cases has been increasing over the past several years. Therefore, HEV infection should be considered in GBS patients who have a history of pork consumption or have been suffering from liver dysfunction.
Full Text of this Article in Japanese PDF (1221K)

(CLINICA NEUROL, 61: 869−873, 2021)
key words: Guillain-Barré syndrome, hepatitis E, pork liver, HEV-IgA, NEV-RNA

(Received: 8-Jul-21)