Acute hepatitis E infection associated with Guillain-Barre syndrome in an immunocompetent patient

Introduction. - Hepatitis E virus (HEV) infection is now recognized to be an emerging autochthonous disease in several countries. There have been several reports of neurological manifestations associated with HEV infections. Immunocompromised patients seem to be particularly vulnerable. Case report. - We report a 73-year-old man who presented with an acute polyradiculopathy and an acute hepatitis. HEV RNA was positive in serum and cerebrospinal fluid. Serum antiganglioside antibodies were also detected. Liver function tests returned to normal rapidly and HEV RNA was undetectable 4 weeks after initial testing. The neurological features improved gradually with the use of intravenous immunoglobulins. Conclusion. - We report a case of Guillain-Barre syndrome related to acute hepatitis E in an immunocompetent patient. The outcome was favorable after intravenous immunoglobulins administration. HEV screening should be systematic in patients who present with an acute polyradiculopathy and abnormal liver function tests. (C) 2013 Published by Elsevier Masson SAS on behalf of the Societe nationale francaise de medecine interne (SNFMI).