Neurologic Disorders and Hepatitis E, France, 2010

We report meningitis with diffuse neuralgic pain or polyradiculoneuropathy associated with PCR-documented acute hepatitis E in 2 adults.These observations suggest that diagnostic testing for hepatitis E virus should be conducted for patients who have neurologic symptoms and liver cytolysis.H epatitis E virus (HEV), a major cause of acute hepatitis in tropical and subtropical countries, is emerging in industrialized countries, where an increasing number of autochthonous hepatitis E cases have been reported (1-5).Nonetheless, the clinical spectrum of HEV infection still might be incompletely characterized.During the past decade, 12 cases of hepatitis E with neurologic signs and symptoms have been reported (1-4,6-13).We report 2 cases of meningitis or polyradiculoneuropathy in association with PCR-documented acute hepatitis E in France during 2010. The CasesCase 1 occurred in a 54-year-old woman hospitalized in August 2010 for subacute diffuse paresthesia and pain of the limbs (with ulnar localization on upper limbs and proximal pain in legs), headaches, cervicalgia, photophonophobia, transient fever, and nausea.Refl exes were all present, without pyramidal signs.No abnormalities were found by medullar magnetic resonance imaging.Nerve conduction study was not done because of rapid clinical improvement beginning <1 week after onset.The patient had no notable medical history.At admission, alanine aminotransferase level was 566 IU/L (reference