[免疫功能正常患者的急性戊型肝炎感染与吉兰-巴雷综合征相关]
[Acute hepatitis E infection associated with Guillain-Barré syndrome in an immunocompetent patient].
作者信息
Comont T, Bonnet D, Sigur N, Gerdelat A, Legrand-Abravanel F, Kamar N, Alric L
机构信息
Service de médecine interne, pôle digestif, CHU Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
Service de neurologie, CHU Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
出版信息
Rev Med Interne. 2014 May;35(5):333-6. doi: 10.1016/j.revmed.2013.05.005. Epub 2013 Sep 27.
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-Barré 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.
引言
戊型肝炎病毒（HEV）感染目前被认为是一些国家中一种新出现的本土疾病。已有几篇关于与HEV感染相关的神经学表现的报道。免疫功能低下的患者似乎特别易受影响。
病例报告
我们报告一名73岁男性，他表现为急性多发性神经根病和急性肝炎。血清和脑脊液中的HEV RNA呈阳性。还检测到血清抗神经节苷脂抗体。肝功能检查迅速恢复正常，初次检测4周后HEV RNA检测不到。使用静脉注射免疫球蛋白后神经学特征逐渐改善。
结论
我们报告了一例免疫功能正常的患者发生与急性戊型肝炎相关的吉兰-巴雷综合征。静脉注射免疫球蛋白后预后良好。对于出现急性多发性神经根病且肝功能检查异常的患者，应进行系统的HEV筛查。
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