Volume 88 - 2025 - Fasc.2 - Letters
Acute hepatitis E-related Guillain-Barré syndrome
To the editor,
Hepatitis E Virus (HEV) is the most common cause of acute viral hepatitis globally. Recent European serosurveys
show age-dependent increases, corresponding to ongoing zoonotic exposure. Despite this, HEV remains
largely underdiagnosed (1,2).
Although usually self-limiting, complications are prolonged cholestasis and rarely acute hepatic failure . A
distinctive feature of HEV is its extra-hepatic involvement with predominant neurologic manifestations, such as
Guillain-Barré Syndrome (GBS) and neuralgic amyotrophy (1).
We here report a case of a 66-year old man with an unexpected diagnosis of HEV-associated GBS, illustrating
the importance of including HEV in the differential diagnosis of neurological symptoms of unknown origin.
His medical history is characterized by Parkinson’s disease and an end-to-end colostomy for rectal carcinoma.
He presented to the emergency ward due to general malaise along with progressive hypoesthesia and slight
weakness in both lower legs and feet. Despite a slight desaturation (91% on room air), the vital parameters were
normal. Blood results showed liver abnormalities, which prompted additional laboratory testing leading to the
diagnosis of acute hepatitis E (Table 1, Fig. 1).
