Case Report
Hepatitis E virus infection presenting with paraesthesia
Scottish Medical Journal 2015, Vol. 60(2) e27–e29 ! The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0036933015572093 scm.sagepub.com
Susan Bennett1, Kathy Li2 and Rory N Gunson3
Abstract Hepatitis E virus infection is an emerging disease in developed countries. Acute and chronic infection has been reported, with chronic infection being increasingly reported in immunocompromised patients. Neurological disorders are an emerging manifestation of both acute and chronic hepatitis E virus infection. We report a 77-year-old female presented with paraesthesia and was found to have abnormal liver function tests. Serology was found to be positive for hepatitis E virus IgM, IgG and RNA. Liver function tests normalised after three weeks and her neurological symptoms completely resolved. To our knowledge, this is the first case in Scotland of hepatitis E virus presenting only with neurological symptoms.
Keywords Hepatitis E virus, neurological, paraesthesia
Introduction Hepatitis E virus infection is an emerging disease in developed countries.1–3 This is mainly thought to be caused via zoonosis from infected pigs, and in Europe infection is generally caused by genotype 3.2 Acute and chronic infection has been reported, with chronic infection being increasingly reported in immunocompromised patients.1,2 Neurological disorders are an emerging manifestation of both acute and chronic hepatitis E virus (HEV) infection.1–10 Here, we describe a patient with HEV presenting with paraesthesia. To our knowledge this is the first case in Scotland of HEV presenting only with neurological symptoms.
Case A 77-year-old female presented with paraesthesia and was found to have abnormal liver function tests (LFTs) and therefore was admitted to hospital by GP referral in March 2014. The patient had a three-day history of pain and tightness in her arms which had spread to behind the legs, but did not affect mobility. The patient was otherwise well with no constitutional upset. The only regular medication taken by the patient was four to six paracetamol tablets per day (2–3 g). A paracetamol level taken at admission was
Hepatitis E virus infection presenting with paraesthesia
Scottish Medical Journal 2015, Vol. 60(2) e27–e29 ! The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0036933015572093 scm.sagepub.com
Susan Bennett1, Kathy Li2 and Rory N Gunson3
Abstract Hepatitis E virus infection is an emerging disease in developed countries. Acute and chronic infection has been reported, with chronic infection being increasingly reported in immunocompromised patients. Neurological disorders are an emerging manifestation of both acute and chronic hepatitis E virus infection. We report a 77-year-old female presented with paraesthesia and was found to have abnormal liver function tests. Serology was found to be positive for hepatitis E virus IgM, IgG and RNA. Liver function tests normalised after three weeks and her neurological symptoms completely resolved. To our knowledge, this is the first case in Scotland of hepatitis E virus presenting only with neurological symptoms.
Keywords Hepatitis E virus, neurological, paraesthesia
Introduction Hepatitis E virus infection is an emerging disease in developed countries.1–3 This is mainly thought to be caused via zoonosis from infected pigs, and in Europe infection is generally caused by genotype 3.2 Acute and chronic infection has been reported, with chronic infection being increasingly reported in immunocompromised patients.1,2 Neurological disorders are an emerging manifestation of both acute and chronic hepatitis E virus (HEV) infection.1–10 Here, we describe a patient with HEV presenting with paraesthesia. To our knowledge this is the first case in Scotland of HEV presenting only with neurological symptoms.
Case A 77-year-old female presented with paraesthesia and was found to have abnormal liver function tests (LFTs) and therefore was admitted to hospital by GP referral in March 2014. The patient had a three-day history of pain and tightness in her arms which had spread to behind the legs, but did not affect mobility. The patient was otherwise well with no constitutional upset. The only regular medication taken by the patient was four to six paracetamol tablets per day (2–3 g). A paracetamol level taken at admission was
