Challenging Diagnosis and Inpatient Rehabilitation of Acute Bilateral Neuralgic Amyotrophy Possibly Attributed to Lyme Disease: A Case Report

Zhang, Shangming; Zhang, Lucy Q.; Wright, Megan E.; Gater, David R.

doi:10.1016/j.pmrj.2017.11.018

Cited by 5 publications

(4 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The frequency of diaphragmatic paresis in everyday clinical practice can only be roughly estimated, and the causes are manifold [1,2]. If a traumatic or postoperative genesis is excluded, as well as neuromuscular diseases, especially ALS (amyotrophic lateral sclerosis), rarer causes such as Lyme disease [2][3][4][5][6][7][8][9][10] should also be considered.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis E and diaphragmatic dysfunction: Case series and review of the literature

Westhoff,

Arias,

Litterst

2024

Pneumologie

View full text Add to dashboard Cite

Introduction The causes of diaphragmatic paresis are manifold. An association between neuralgic amyotrophy (NA) and hepatitis E virus (HEV) infection has been reported. We wondered about the prevalence of diaphragmatic disfunction and hepatitis E infection in our clinic. Methods From July 1st, 2020 to August 31st, 2023, patients presenting with diaphragmatic dysfunction and simultaneous clinical symptoms of an acute NA, or a history of NA, as well as patients with previously unexplained diaphragmatic dysfunction were examined for HEV infection. Results By August 31st, 2023, 13 patients with diaphragmatic dysfunction and HEV infection were diagnosed (4 women, 9 men). Mean age was 59 ± 10 years. Liver values were normal in all patients. The median latency to diagnosis was five months (range: 1–48 months); nine patients, 4 of them with typical symptoms of NA, presented with acute onset three patients showed bilateral diaphragmatic dysfunction. All patients had a positive IgG immunoblot. Seven patients, three with NA, had an elevated hepatitis E IgM titer and six of them also a positive IgM immunoblot. In all cases, O2C hepatitis genotype 3 was identified. In eight cases, all those with a high IgG titer >125, the O2 genotype 1 was also detected. Conclusion NA that shows involvement of the phrenic nerve resulting in diaphragmatic dysfunction and dyspnoea, may be associated with HEV infection. The observation of 13 patients with diaphragmatic dysfunctions and HEV infection within a period of three years indicates a high number of undetected HEV-associated diaphragmatic dysfunction in the population, especially in the absence of NA symptoms. Therefore, even in diaphragmatic dysfunction without NA symptoms and causative damaging event, HEV infection should be considered, as it may represent a subform of NA with only phrenic nerve involvement. Therapy of HEV-associated diaphragmatic dysfunction in the acute phase is an open question. In view of the poor prognosis for recovery, antiviral therapy should be discussed. However, no relevant data are currently available.

show abstract

Section: Discussionmentioning

confidence: 99%

Hepatitis E and diaphragmatic dysfunction: Case series and review of the literature

Westhoff,

Arias,

Litterst

2024

Pneumologie

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Alles unter Kontrolle?

Eggeling,

Kalsdorf,

Schaub

et al. 2024

Pneumologie

View full text Add to dashboard Cite

ZusammenfassungEin 43-jähriger Steinbrucharbeiter steht nach 16-jähriger Exposition gegenüber Quarzfeinstaub in einem deutschen Steinbruch auf der Warteliste für eine Lungentransplantation: Die Inhalation des Feinstaubs schädigte die Lunge irreversibel und begünstigte das Auftreten fulminanter mykobakterieller und mykotischer Infektionen, die bereits zur einseitigen Pneumektomie und zunehmenden respiratorischen Insuffizienz führten. Trotz regelmäßiger Überwachungen durch die Berufsgenossenschaft konnte diese dramatische Entwicklung der Silikose nicht verhindert werden.

show abstract

“…Кроме того, при билатеральном поражении болевой синдром возникает одновременно с обеих сторон [3], тогда как у нашего больного боль в другом плече появилась с интервалом в сутки. Двустороннее поражение плечевого сплетения при НА требует исключения таких состояний, как гепатит Е, ВИЧ-инфекция, Лайм-боррелиоз [4][5][6]. Однако развитие НА у пациента в зимний период позволило не проводить обследование крови и ликвора на наличие антител к боррелиям, с учетом того, что последнее размножение иксодовых клещей наблюдается в конце августа -начале сентября, когда возможно получить укус клеща, и 2-я фаза Лайм-боррелиоза (т.е.…”

Section: Discussionunclassified