Extra-hepatic manifestations of autochthonous hepatitis E infection.
Autor(es): Woolson K. L.; Forbes A.; Vine L.; Beynon L.; McElhinney L.; Panayi V.; Hunter J. G.; Madden R. G.; Glasgow T.; Kotecha A.; Dalton H. C.; Mihailescu L.; Warshow U.; Hussaini H. S.; Palmer J.; Mclean B. N.; Haywood B.; Bendall R. P.; Dalton H. R.
Resumo: Autochthonous (locally acquired) hepatitis E is increasingly recognised in developed countries, and is thought to be a porcine zoonosis. A range of extra-hepatic manifestations of hepatitis E infection have been described, but have never been systematically studied. To report the extra-hepatic manifestations of hepatitis E virus. Retrospective review of data of 106 cases of autochthonous hepatitis E (acute n = 105, chronic n = 1). Eight (7.5%) cases presented with neurological syndromes, which included brachial neuritis, Guillain-Barré syndrome, peripheral neuropathy, neuromyopathy and vestibular neuritis. Patients with neurological syndromes were younger (median age 40 years, range 34-92 years, P = 0.048) and had a more modest transaminitis (median ALT 471 IU/L, P = 0.015) compared to cases without neurological symptoms [median age 64 years (range 18-88 years), median ALT 1135 IU/L]. One patient presented with a cardiac arrhythmia,twelve patients (11.3%) presented with thrombocytopenia, fourteen (13.2%) with lymphocytosis and eight (7.5%) with a lymphopenia, none of which had any clinical consequence. Serum electrophoresis was performed in 65 patients at presentation, of whom 17 (26%) had a monoclonal gammopathy of uncertain significance. Two cases developed haematological malignancies, acute myeloid leukaemia and duodenal plasmacytoma, 18 and 36 months after presenting with acute hepatitis E infection. A range of extra-hepatic manifestations can occur with hepatitis E. Neurological and haematological features of hepatitis E infection are relatively frequent in this UK cohort, and result in significant morbidity which warrants further study.
Imprenta: Alimentary Pharmacology & Therapeutics, v. 40, n. 11-12, p. 1282-1291, 2014
Identificador do objeto digital: 10.1111/apt.12986
Descritores: Guillain-Barre Syndrome - Cytopathology ; Guillain-Barre Syndrome - Pathogenesis ; Guillain-Barre Syndrome - Viral infections ; Guillain-Barre Syndrome - Molecular methods ; Guillain-Barre Syndrome - Virus ; Guillain-Barre Syndrome - Molecular screening ; Guillain-Barre Syndrome - Epidemiology ; Guillain-Barre Syndrome - Public health
Data de publicação: 2014
