RESUMEN
Neurologic disorders, mainly Guillain-Barré syndrome and ParsonageTurner syndrome (PTS), have been described in patients with hepatitis E virus (HEV) infection in industrialized and developing countries. We report a wider range of neurologic disorders in nonimmunocompromised patients with acute HEV infection. Data from 15 French immunocompetent patients with acute HEV infection and neurologic disorders were retrospectively recorded from January 2006 through June 2013. The disorders could be divided into 4 main entities: mononeuritis multiplex, PTS, meningoradiculitis, and acute demyelinating neuropathy. HEV infection was treated with ribavirin in 3 patients (for PTS or mononeuritis multiplex). One patient was treated with corticosteroids (for mononeuropathy multiplex), and 5 others received intravenous immunoglobulin (for PTS, meningoradiculitis, Guillain-Barré syndrome, or Miller Fisher syndrome). We conclude that pleiotropic neurologic disorders are seen in HEV-infected immunocompetent patients. Patients with acute neurologic manifestations and aminotransferase abnormalities should be screened for HEV infection.
Asunto(s)
Enfermedad Aguda/mortalidad , Hepatitis E/complicaciones , Inmunocompetencia , Enfermedades del Sistema Nervioso/etiología , Adulto , Anciano , Educación Médica Continua , Femenino , Hepatitis E/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/mortalidadRESUMEN
On the basis of 4 adult population samples subsequently gathered into one sample of 567 healthy subjects, we determined: (1) the annual prevalence of symptoms suggestive of intestinal functional disorders (30.5 per cent); (2) the elements which prompted subjects with symptoms to request medical attention (we found that the request was significantly correlated with the duration of pain, the intensity and chronicity of constipation, the number of symptoms and the triggering of disorders by stress), and (3) an estimate of the "cost" of intestinal functional disorders.