Key result
A 52-year-old man developed neuralgic amyotrophy with left phrenic neuropathy and bilateral C5-C6 denervation associated with acute hepatitis E infection.
Case Report (n=1)
Hepatitis E should be considered in patients presenting with neuralgic amyotrophy, especially men with bilateral symptoms and unexplained elevated transaminases.
Single case links hepatitis E to neuralgic amyotrophy; hypothesis-generating and should not yet change practice.
Hepatitis E is an emerging viral infection in developed countries. It can present with multiple extra-hepatic manifestations, including neuralgic amyotrophy. We report a 52-year-old man who presented with neck and shoulder pain followed by orthopnea and left arm weakness. Electrodiagnostic testing showed left phrenic neuropathy and denervation in bilateral C5 and C6 myotomes. He also had elevated liver enzymes, which led to the diagnosis of acute hepatitis E. This is the first case of neuralgic amyotrophy associated with hepatitis E in the United States. Hepatitis E should be considered in patients with neuralgic amyotrophy, particularly men with bilateral symptoms, and if there is unexplained elevation of transaminases. The role of antiviral therapy remains unclear.
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Avila et al. (2016) conducted a case report in Neuralgic amyotrophy associated with hepatitis E (n=1). Hepatitis E virus infection was evaluated on Clinical presentation and diagnosis. A 52-year-old man developed neuralgic amyotrophy with left phrenic neuropathy and bilateral C5-C6 denervation associated with acute hepatitis E infection.
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