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Hepatitis E Virus


Presentation

  • The present study highlights the need for molecular diagnosis in the case of HEV infection with strong clinical suspicion and negative serological results.[ncbi.nlm.nih.gov]
  • To our knowledge, this is the first case in Scotland of hepatitis E virus presenting only with neurological symptoms.[ncbi.nlm.nih.gov]
  • In this report, we present a case of a 50-year-old immunocompetent man with Guillain-Barré syndrome (GBS) associated with an autochthonous hepatitis E virus (HEV) infection. The patient presented with tetraparesis and elevated liver enzymes.[ncbi.nlm.nih.gov]
  • ET1.1 did however, hybridize to an approximately 7.6-kilobase RNA species present only in infected cyno liver.[ncbi.nlm.nih.gov]
  • Several point mutations scattered along the whole genome were present in the HEV strain from the second passage; however, the ORF1 insertion was still present.[ncbi.nlm.nih.gov]
Recurrent Infection
  • However, because of recurrent infections, this patient was not able to complete treatment. Patient died shortly after his second cycle of alemtuzumab because of complications of meningitis and secondary sepsis with E coli .[bloodjournal.org]
Severe Pain
  • Abstract We report the case of a Thai male patient with neuralgic amyotrophy, presenting with acute and severe pain in the upper extremities, followed by patchy muscle weakness, associated with hepatitis E virus (HEV) infection.[ncbi.nlm.nih.gov]
Muscle Weakness
  • Abstract We report the case of a Thai male patient with neuralgic amyotrophy, presenting with acute and severe pain in the upper extremities, followed by patchy muscle weakness, associated with hepatitis E virus (HEV) infection.[ncbi.nlm.nih.gov]
Paresis
  • Then, the literature was searched for reports of HEV-NA (n 39), and neuralgic amyotrophy with phrenic paresis (n 42) from 1999 to June 2016.[ncbi.nlm.nih.gov]
  • Then, the literature was searched for reports of HEV-NA ( n 39), and neuralgic amyotrophy with phrenic paresis ( n 42) from 1999 to June 2016.[springermedizin.de]
  • Patient 2 developed mild GBS, with predominantly sensory symptoms (paresthesia and pain) and mild paresis (limbs and mild dysarthria) without ataxia or areflexia; he received no immunomodulatory treatment.[jamanetwork.com]
Paresthesia
  • Herein, we report the case of an immunocompetent patient who was admitted to our hospital with paresthesia and weakness in both the upper extremities associated with anicteric-elevated transaminases.[ncbi.nlm.nih.gov]
  • Patient 2 developed mild GBS, with predominantly sensory symptoms (paresthesia and pain) and mild paresis (limbs and mild dysarthria) without ataxia or areflexia; he received no immunomodulatory treatment.[jamanetwork.com]
Mononeuropathy
  • The neuralgic amyotrophy may be of difficult diagnosis, due to phenotypic variability, with different initial presentations (upper plexus multiple mononeuropathy, lumbosacral involvement, distal reached, phrenic involvement).[ncbi.nlm.nih.gov]
  • Abstract The neuralgic amyotrophy may be of difficult diagnosis, due to phenotypic variability, with different initial presentations (upper plexus multiple mononeuropathy, lumbosacral involvement, distal reached, phrenic involvement).[springermedizin.de]
Stroke
  • KEYWORDS: Epidemiology; Hepatitis E virus (HEV); Neuralgic amyotrophy; Seizure; Stroke[ncbi.nlm.nih.gov]

Workup

  • […] acute hepatitis when baseline workup is inconclusive.[ncbi.nlm.nih.gov]
  • As such, HEV should be part of the laboratory workup of any lymphoproliferation, particularly those of the T cell phenotype that involve the skin.[ncbi.nlm.nih.gov]
  • Further studies are required to guide neurologists in their workup of underlying triggers of GBS.[jamanetwork.com]
Pericardial Effusion
  • Despite intensive care the patient died 39 days after admission due to pericardial effusion that was related to acute liver failure.[ncbi.nlm.nih.gov]

Treatment

  • In the context of HEV-associated cutaneous T cell lymphoproliferative disorders, antiviral treatment could be considered a first-line treatment instead of chemotherapy.[ncbi.nlm.nih.gov]
  • Since zinc supplementation therapy is known to be safe in healthy individuals and since high-dose zinc is used in the treatment of Wilson's disease, it may be possible to control HEV-associated health problems following a similar treatment regimen.[ncbi.nlm.nih.gov]
  • After treatment with intravenous immunoglobulins, the patient made a rapid recovery. Here, we report the first case of GBS due to acute hepatitis E virus (HEV) infection associated with the presence of anti-ganglioside GM1 antibodies.[ncbi.nlm.nih.gov]
  • Treatment was started with propranolol and carbimazol whereupon hepatitis and hyperthyroidism resolved.[ncbi.nlm.nih.gov]
  • Patient improved completely with symptomatic treatment. We suggest offering diagnostic testing for Hepatitis E virus in patients of neurological disorders with concurrent liver impairment.[ncbi.nlm.nih.gov]

Prognosis

  • Although the role of ribavirin remains to be fully determined, early diagnosis and treatment may result in an improved prognosis, thereby minimizing neurological sequelae. [Indexed for MEDLINE] Free full text[ncbi.nlm.nih.gov]
  • Patients with underlying chronic liver disease have a poor prognosis with a mortality of 27% 14 ; their cause of death is usually (sub)acute liver failure.[pn.bmj.com]

Etiology

  • Author information 1 Centre de Néphrologie et Transplantation Rénale, Hôpital Conception, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France. vmoal@ap-hm.fr Abstract Hepatitis E virus (HEV), the main etiologic agent[ncbi.nlm.nih.gov]
  • Department of Microbiology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia. 3 Atta-Ur-Rahman School of Applied Biosciences, National University of Science and Technology, Islamabad, Pakistan. 4 State Key Laboratory of Veterinary Etiological[ncbi.nlm.nih.gov]
  • Bradley DW, Andjaparidze AG, Cook EH, McCaustland K, Balayan M, Stetler H, Velazques O, Robertson B, Humphrey C, Kane M, Weisfuse I (1988) Etiologic agent of enterically transmitted non-A, non-B hepatitis.[link.springer.com]

Epidemiology

  • This does not infer blame on the supermarket but the epidemiology of HEV is dynamic and reflects complex animal husbandry practices which need to be explored further. KEYWORDS: Epidemiology; hepatitis E; zoonoses; zoonotic foodborne diseases[ncbi.nlm.nih.gov]
  • Author information 1 Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany. 2 Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany. 3 Department of Epidemiology and[ncbi.nlm.nih.gov]
  • Author information 1 ANSES, Ploufragan-Plouzané Laboratory, Swine Epidemiology and Welfare Research Unit, Ploufragan, France; Université Bretagne-Loire, Rennes, France.[ncbi.nlm.nih.gov]
  • The unique characteristics of HEV is that it displays different epidemiological and clinical characteristics between developing and developed countries.[ncbi.nlm.nih.gov]
  • Project summary The epidemiology of HEV infections in Belgium is not well described, and the zoonotic aspects were only recently recognised. In this project, we examine the epidemiology of HEV in Belgium.[sciensano.be]
Sex distribution
Age distribution

Pathophysiology

  • Objective: This review aimed at summarizing the role played by HEV on the exacerbation of chronic hepatitis B and the pathophysiology of acute-on-chronic liver failure.[amhsr.org]
  • Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Hepatitis E virus (HEV) causes an acute, usually self-limited infection.[mayomedicallaboratories.com]
  • Van Alfen N (2011) Clinical and pathophysiological concepts of neuralgic amyotrophy. Nat Rev Neurol 7:315–322 CrossRef PubMed 3.[springermedizin.de]
  • Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Hepatitis E virus (HEV) is a causative agent of acute self-limited or fulminant hepatitis.[mayomedicallaboratories.com]

Prevention

  • Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China.[ncbi.nlm.nih.gov]
  • Our findings call for action in validating the above-mentioned features that illustrate the HEV-NA cases as an early diagnosis would prevent complications, especially the phrenic damage often associated with a worse functional outcome.[ncbi.nlm.nih.gov]
  • It is urgent to improve integrated strategies to detect, prevent and control HEV infection in dogs and humans exposed to dogs in this area. 2017 Blackwell Verlag GmbH.[ncbi.nlm.nih.gov]
  • They also suggest that active surveillance and appropriate measures targeting community and routine individual health actions are important to prevent transmission and decrease the deaths.[ncbi.nlm.nih.gov]
  • Studies on the true burden of the disease, specific risk factors and sources of autochthonous infections as well as targeted prevention measures are urgently needed. 2018 John Wiley & Sons Ltd.[ncbi.nlm.nih.gov]

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