Table 2 Clinical and diagnostic features of patients with an acute HEV infection
From: Hepatitis E virus as a trigger for Guillain-Barré syndrome
Patient 1 | Patient 2 | |
|---|---|---|
Age, sex | 56, female | 65, male |
Subtype | AMSAN | Classical GBS |
Symptoms | ||
Cranial Nerves | Diplopia, right-sided trigeminal hypesthesia | – |
Motor | Flaccid tetraparesis, areflexia | Slight weakness in both arms, areflexia |
Sensory | Hypesthesia of both legs | Hypesthesia of distal extremities, pallhypesthesia with gait ataxia |
Autonomic | Reduced vital capacity | – |
GBS disability index | ||
Nadir | 5 | 2 |
Discharge | 4 | 1 |
Time from symptom onset to analysis | 6 weeks | 5.5 weeks |
Medical History | Type 2 diabetes, arterial hypertension, hypercholesterolemia, diabetic polyneuropathy, vitamin B12 deficiency, alcohol abuse, chronic pancreatitis, former Hepatitis A and B infection, former pontine stroke | Arterial hypertension, monoclonal gammopathy type IgG lambda |
Travel history | None | None |
HEV Status | ||
Serology | ||
IgM (AU/ml) | Positive (7.54) | Positive (1.06) |
IgG (AU/ml) | Positive (17.78) | Positive (14.60) |
PCR serum/CSF | Negative/negative | Negative/negative |
CSF | ||
WBC (/μl) | 3 | 3 |
Protein (mg/l) | 448 | 600 (↑) |
QAlb (×10−3) | 7.2 | 7.1 |
Liver function tests | ||
AST (U/l) | 24 | 37 |
ALT (U/l) | 10 | 40 |
Antibodies | ||
(GM1,GQ1b, GD1) | Negative | Not available |
Electrophysiology | ||
Demyelination | – | ++ |
Axonal Damage | ++ | + |