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Journal of Case Reports
Guillain-Barré Syndrome Linked to Hepatitis E Virus
Rahul Turkar, Sayed Asad Jalil, VM Naik
Department of Internal Medicine, Mumbai Port Authority Hospital, Mumbai, Maharashtra, India.
Corresponding Author:
Dr Rahul Turkar
Email: turkar.rahul235@gmail.com
Received: 12-JAN-2024 Accepted: 02-JUL-2024 Published Online: 05-NOV-2024
DOI: http://dx.doi.org/10.17659/01.2024.0025
Abstract
Background: Hepatitis E virus (HEV) infection typically presents with hepatic symptoms, it can also lead to a range of extra-hepatic manifestations, including neurological complications. Among these, Guillain-Barré syndrome (GBS) has emerged as an important, though rare, HEV-associated neurological disorder. Case Report: We report a case of a 70-year-old man with acute HEV infection who initially presented with general fatigue, anorexia, mild jaundice, and tea-coloured urine. Despite liver-protective treatment, on the fifth day of admission, he developed progressive muscle weakness, numbness, and an inability to walk. Neurological examination confirmed rapidly worsening symmetrical weakness in all limbs, along with facial nerve palsy and absent reflexes in the lower extremities. GBS was suspected, and cerebrospinal fluid (CSF) analysis showed albumin-cytologic dissociation, while nerve conduction studies confirmed sensori-motor radiculo-neuropathy. Serology was positive for IgM and IgG anti-HEV antibodies, and HEV-associated GBS was diagnosed. The patient was treated with intravenous immunoglobulin (IVIG) and methylprednisolone, showing gradual improvement over the next two weeks. Conclusion: HEV infection, though primarily hepatic, can present with severe neurological manifestations such as GBS. Early recognition of HEV-associated GBS can prevent complications and improve prognosis.
Keywords : Facial Palsy, Hepatitis, Jaundice, Neurological Disorders, Weakness.
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