Hepatitis E infection complicated by bilateral neuralgic amyotrophy and phrenic nerve palsy: a case report

Hepatitis E is an increasingly recognized cause of acute hepatitis in the Western world and is often complicated by extrahepatic manifestations, particularly neurological ones such as neuralgic amyotrophy (NA). NA is a disease of the brachial plexus, characterized by sudden onset of severe pain and muscle weakness, typically affecting the shoulders and upper limbs and can even extend to the diaphragm. Recent data suggest that its presence is linked to a HEV infection in 10% of the cases. Due to its rarity, there are currently no established treatment guidelines. Here we present a case of a 44-year-old man who developed bilateral NA and phrenic nerve palsy as a consequence of an acute hepatitis E infection.