Extra‐hepatic manifestations of autochthonous hepatitis E infection

• DOI: 10.1111/apt.12986
• Publication Date: 2014-10-10T04:41:24Z
• Authors: K. L. Woolson; A. Forbes; L. Vine; L. Beynon; L. McElhinney; V. Panayi; J. G. Hunter; R. G. Madden; T. Glasgow; A. Kotecha; H. C. Dalton; L. Mihailescu; U. Warshow; H. S. Hussaini; J. Palmer; B. N. Mclean; B. Haywood; R. P. Bendall; H. R. Dalton
• Keywords: Hepatitis E; Hepatitis E Virus; Lymphocytosis; Elevated transaminases

Summary Background Autochthonous (locally acquired) hepatitis E is increasingly recognised in developed countries, and thought to be a porcine zoonosis. A range of extra‐hepatic manifestations infection have been described, but never systematically studied. Aim To report the virus. Methods Retrospective review data 106 cases autochthonous (acute n = 105, chronic 1). Results Eight (7.5%) presented with neurological syndromes, which included brachial neuritis, Guillain‐Barré syndrome, peripheral neuropathy, neuromyopathy vestibular neuritis. Patients syndromes were younger (median age 40 years, 34–92 P 0.048) had more modest transaminitis ALT 471 IU/L, 0.015) compared without symptoms [median 64 years (range 18–88 years), median 1135 IU/L]. One patient cardiac arrhythmia,twelve patients (11.3%) thrombocytopenia, fourteen (13.2%) lymphocytosis eight lymphopenia, none any clinical consequence. Serum electrophoresis was performed 65 at presentation, whom 17 (26%) monoclonal gammopathy uncertain significance. Two haematological malignancies, acute myeloid leukaemia duodenal plasmacytoma, 18 36 months after presenting infection. Conclusions can occur E. Neurological features are relatively frequent this UK cohort, result significant morbidity warrants further study.