Hepatitis E virus as a trigger for Guillain-Barré syndrome
Abstract Background Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. An association with neuralgic amyotrophy and Guillain-Barré syndrome (GBS) was previously described. Concerning GBS, studies from other countries found an acute HEV infection in 5–11% of cases. H...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-021-02334-1 |
| _version_ | 1818832881995218944 |
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| author | Miriam Fritz-Weltin Estelle Frommherz Nora Isenmann Lisa Niedermeier Benedikt Csernalabics Tobias Boettler Christoph Neumann-Haefelin Dominique Endres Marcus Panning Benjamin Berger |
| author_facet | Miriam Fritz-Weltin Estelle Frommherz Nora Isenmann Lisa Niedermeier Benedikt Csernalabics Tobias Boettler Christoph Neumann-Haefelin Dominique Endres Marcus Panning Benjamin Berger |
| author_sort | Miriam Fritz-Weltin |
| collection | DOAJ |
| description | Abstract Background Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. An association with neuralgic amyotrophy and Guillain-Barré syndrome (GBS) was previously described. Concerning GBS, studies from other countries found an acute HEV infection in 5–11% of cases. However, HEV prevalence shows considerable regional variations. Therefore, we retrospectively analyzed the frequency of HEV infections in association with GBS in a monocentric cohort in Southwestern Germany. Methods Overall, 163 patients with GBS treated in our clinic between 2008 and 2018 of whom serum and/or cerebrospinal fluid (CSF) samples were available, were identified. Serum samples were analyzed for anti-HEV immunoglobulin (Ig)M and IgG antibodies by ELISA. Additionally, both serum and cerebrospinal fluid (CSF) samples were tested for HEV RNA by PCR if IgM was positive or patients presented within the first 7 days from GBS symptom onset. A group of 167 healthy volunteers and 96 healthy blood donors served as controls. Results An acute HEV infection was found in two GBS patients (1.2%) with anti-HEV IgM and IgG antibodies. HEV PCR in serum and CSF was negative in these two patients as well as in all other tested cases. Seroprevalences indicated that acute infection did not differ significantly from controls (0.8%). Anti-HEV IgG seroprevalence indicating previous infection was unexpectedly high (41%) and revealed an age-dependent increase to more than 50% in patients older than 60 years. Conclusion In this study, serological evidence of an acute HEV infection in patients with GBS was rare and not different from controls. Comparing our data with previous studies, incidence rates show considerable regional variations. |
| first_indexed | 2024-12-19T02:10:05Z |
| format | Article |
| id | doaj.art-dc91951f816143e99049047186e529e8 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-19T02:10:05Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-dc91951f816143e99049047186e529e82022-12-21T20:40:49ZengBMCBMC Neurology1471-23772021-08-012111910.1186/s12883-021-02334-1Hepatitis E virus as a trigger for Guillain-Barré syndromeMiriam Fritz-Weltin0Estelle Frommherz1Nora Isenmann2Lisa Niedermeier3Benedikt Csernalabics4Tobias Boettler5Christoph Neumann-Haefelin6Dominique Endres7Marcus Panning8Benjamin Berger9Clinic of Neurology and Neurophysiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgClinic of Neurology and Neurophysiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgClinic of Neurology and Neurophysiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgClinic of Neurology and Neurophysiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Medicine II, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Medicine II, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Medicine II, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgInstitute of Virology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgClinic of Neurology and Neurophysiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgAbstract Background Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. An association with neuralgic amyotrophy and Guillain-Barré syndrome (GBS) was previously described. Concerning GBS, studies from other countries found an acute HEV infection in 5–11% of cases. However, HEV prevalence shows considerable regional variations. Therefore, we retrospectively analyzed the frequency of HEV infections in association with GBS in a monocentric cohort in Southwestern Germany. Methods Overall, 163 patients with GBS treated in our clinic between 2008 and 2018 of whom serum and/or cerebrospinal fluid (CSF) samples were available, were identified. Serum samples were analyzed for anti-HEV immunoglobulin (Ig)M and IgG antibodies by ELISA. Additionally, both serum and cerebrospinal fluid (CSF) samples were tested for HEV RNA by PCR if IgM was positive or patients presented within the first 7 days from GBS symptom onset. A group of 167 healthy volunteers and 96 healthy blood donors served as controls. Results An acute HEV infection was found in two GBS patients (1.2%) with anti-HEV IgM and IgG antibodies. HEV PCR in serum and CSF was negative in these two patients as well as in all other tested cases. Seroprevalences indicated that acute infection did not differ significantly from controls (0.8%). Anti-HEV IgG seroprevalence indicating previous infection was unexpectedly high (41%) and revealed an age-dependent increase to more than 50% in patients older than 60 years. Conclusion In this study, serological evidence of an acute HEV infection in patients with GBS was rare and not different from controls. Comparing our data with previous studies, incidence rates show considerable regional variations.https://doi.org/10.1186/s12883-021-02334-1Hepatitis E virusGuillain-Barré syndromeAcute polyneuroradiculitisHEV seroprevalence |
| spellingShingle | Miriam Fritz-Weltin Estelle Frommherz Nora Isenmann Lisa Niedermeier Benedikt Csernalabics Tobias Boettler Christoph Neumann-Haefelin Dominique Endres Marcus Panning Benjamin Berger Hepatitis E virus as a trigger for Guillain-Barré syndrome BMC Neurology Hepatitis E virus Guillain-Barré syndrome Acute polyneuroradiculitis HEV seroprevalence |
| title | Hepatitis E virus as a trigger for Guillain-Barré syndrome |
| title_full | Hepatitis E virus as a trigger for Guillain-Barré syndrome |
| title_fullStr | Hepatitis E virus as a trigger for Guillain-Barré syndrome |
| title_full_unstemmed | Hepatitis E virus as a trigger for Guillain-Barré syndrome |
| title_short | Hepatitis E virus as a trigger for Guillain-Barré syndrome |
| title_sort | hepatitis e virus as a trigger for guillain barre syndrome |
| topic | Hepatitis E virus Guillain-Barré syndrome Acute polyneuroradiculitis HEV seroprevalence |
| url | https://doi.org/10.1186/s12883-021-02334-1 |
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