Guillain-Barré syndrome following hepatitis E

Abstract

Guillain-Barré syndrome (GBS) is often triggered by a preceding bacterial or viral infection. Occasionally, it has been observed in association with acute hepatitis A, B and C, and three cases have been previously described in India in which GBS was associated with acute hepatitis E. A molecular mimicry mechanism is supposed to be involved in the pathogenesis of GBS triggered by infectious agents, although the nature of the shared epitopes has not been characterized in most instances, including that in the case of hepatotropic viruses. We report a case of GBS following acute hepatitis E in a European individual. The presence of antiganglioside GM2 antibodies in this patient suggested molecular mimicry involving ganglioside GM2 in the pathogenesis of GBS associated with hepatitis E.

Host Immune Status and Response to Hepatitis E Virus Infection

“…Several case reports have noted neurological symptoms during or shortly after acute infection, such as meningitis (37), meningoencephalitis (38), acute transverse myelitis (39), Guillain-Barré syndrome (40)(41)(42)(43)(44)(45)(46), and other peripheral neuropathies (47,48). However, these presentations appear to be relatively infrequent.…”

Chronic Hepatitis E Virus Infection and Treatment

“…During the acute phases of HEV genotype-1 and -3 infections, neurological manifestations, such as GuillainÀBarre syndrome, 48,[86][87][88][89][90][91][92][93] Bell's palsy, 94 neuralgic amyotrophy, 95,96 acute transverse myelitis, 97 and acute meningoencephalitis 90,98 have been reported. Neurological symptoms occur in an estimated 5.5% of HEV patients.…”

Association of Bell's Palsy with Hepatitis E Virus Infection: A Rare Entity

“…immunoglobulins/plasmapheresis. 1,6,8,9,13,14,[16][17][18] In immunocompromised organ-transplant patients, dose modification or cessation of immunosuppressant drugs was done. 1 In a patient of retroviral infection, pegylated interferon/ ribavirin was given for painful sensory peripheral neuropathy.…”

“…1 Neurologic involvement in HEV is distinctly rare and approximately 24 cases have been described so far. 1,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Reports of 22 cases are summarized in Table 1. 1,[6][7][8][9][10][11][13][14][15][16][17][18][19][20] Guillain-Barré syndrome, 1,6 (Table 1).…”