Hepatitis E virus infections in patients with MS on oral disease-modifying treatment.
Neurol Neuroimmunol Neuroinflamm
; 6(5)2019 09.
Article
en En
| MEDLINE
| ID: mdl-31454772
OBJECTIVE: To test whether patients with MS on disease-modifying treatments (DMTs) are at a higher risk of acute or chronic hepatitis E virus (HEV) infections or extrahepatic manifestations, we monitored approximately 1,100 persons with MS (pwMS) during 3 years for HEV infection. METHODS: This is an observational case series study. All pwMS were followed in our MS center between January 2016 and December 2018 with at least annual standardized clinical and laboratory assessments. Patients with unexplained liver enzyme elevations were routinely screened for HEV infection. RESULTS: Four cases of acute HEV under DMT (fingolimod [n = 3]; dimethyl fumarate [n = 1]) were identified. Two presented with fulminant icteric hepatitis and one with a HEV-associated neurologic manifestation (neuralgic amyotrophy). No chronic HEV courses were observed. DMT was continued after clearing of HEV or normalization of liver function tests in all cases. CONCLUSION: HEV infection is an important differential diagnosis of drug-induced liver injury in pwMS under DMT. Our data do not suggest an increased incidence of acute HEV infections or chronification in pwMS. However, epidemiologic studies in immunomodulatory-treated patients are needed to further investigate HEV disease courses and extrahepatic manifestations.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedades Desmielinizantes
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Hepatitis E
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Esclerosis Múltiple Recurrente-Remitente
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Enfermedad Hepática Inducida por Sustancias y Drogas
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Inmunosupresores
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Adult
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Neurol Neuroimmunol Neuroinflamm
Año:
2019
Tipo del documento:
Article
País de afiliación:
Suiza
Pais de publicación:
Estados Unidos