Tarisawa Monami, Ando Ryo, Eguchi Katsuki, Abe Megumi, Matsushima Masaaki, Yabe Ichiro
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University.
Department of Gastroenterology, Teine Keijinkai Hospital.
Rinsho Shinkeigaku. 2021 Dec 22;61(12):869-873. doi: 10.5692/clinicalneurol.cn-001666. Epub 2021 Nov 18.
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.
一名81岁男性在食用猪肝约10天后出现肢体无力和感觉异常。他的神经系统检查显示肌肉无力主要集中在下肢,且深部腱反射消失,脑脊液分析显示蛋白升高而细胞计数正常。此外,他的神经传导研究显示双侧正中神经、尺神经、胫神经和腓总神经的远端运动潜伏期延长,运动神经传导速度降低。最后,对戊型肝炎病毒标志物进行了血清学分析,结果戊型肝炎病毒(HEV)-IgA抗体和HEV-RNA呈阳性。综合所有这些发现,该患者被诊断为急性HEV相关格林-巴利综合征(GBS),并给予静脉注射免疫球蛋白治疗5天。此后,肌肉无力和感觉异常逐渐改善。正如本报告中所观察到的,在过去几年中,HEV相关GBS病例的数量一直在增加。因此,对于有食用猪肉史或患有肝功能障碍的GBS患者,应考虑戊型肝炎病毒感染。