We report here a case of acute hepatitis A, which was complicated by Guillain-Barr? syndrome (GBS). A 32-year old male admitted to our hospital with the symptoms of acute hepatitis and was diagnosed to have acute hepatitis A with positive IgM anti hepatitis A virus antibody. On 9th day after the onset of jaundice, acute progressive, ascending, symmetric motor paralysis were developed and eventually respiratory failure ensued. Cerebrospinal fluid analysis showed albumino-cytologic dissociation and nerve conduction velocity test suggested a polyradiculopathy. He was diagnosed to have GBS and treated with intravenous immunoglobulin and required a ventilatory support. After 90 hospital days, he recovered in ambulatory condition with the aid of crutches. The clinical course, prognosis and the outcome of neuropathic symptoms of GBS following acute hepatitis A were relatively poor in our case.
Acute Disease ; Adult ; Guillain-Barre Syndrome/*diagnosis/etiology/therapy ; Hepatitis A/complications/*diagnosis ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Male

Acute motor and sensory axonal neuropathy (AMSAN) are recently described subtypes of Guillain-Barre syndrome characterized by acute onset of distal weakness, loss of deep tendon reflexes, and sensory symptoms. A 21-yr-old male was transferred to our hospital due to respiration difficulties and progressive weakness. In laboratory findings, immunoglobulin M antibodies against hepatitis A were detected in blood and cerebrospinal fluid. The findings of motor nerve conduction studies showed markedly reduced amplitudes of compound muscle action potentials in bilateral peroneal, and posterior tibial nerves, without evidence of demyelination. Based on clinical features, laboratory findings, and electrophysiologic investigation, the patient was diagnosed the AMSAN following acute hepatitis A viral infection. The patient was treated with intravenous immunoglobulin and recovered slowly. Clinicians should consider this rare but a serious case of AMSAN following acute hepatitis A infection.
Acute Disease ; Electromyography ; Guillain-Barre Syndrome/*diagnosis/drug therapy/etiology ; Hepatitis A/complications/*diagnosis ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Male ; Young Adult

Both Graves disease and Guillain-Barre syndrome (GBS) are autoimmune disorders caused by impaired self-tolerance mechanisms and triggered by interactions between genetic and environmental factors. GBS in patients who suffer from other autoimmune diseases is rarely reported, and the development of postinfectious GBS in a patient with Graves disease has not been previously reported in the literature. Herein, we report a patient with Graves disease who developed postinfectious GBS during a course of methimazole-induced agranulocytosis.
Agranulocytosis/*chemically induced/diagnosis/therapy ; Antithyroid Agents/*adverse effects ; Female ; Graves Disease/diagnosis/*drug therapy ; Guillain-Barre Syndrome/diagnosis/*etiology/therapy ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Methimazole/*adverse effects ; Middle Aged ; Opportunistic Infections/diagnosis/*etiology/therapy ; Thyroidectomy ; Treatment Outcome

Biomarkers ; blood ; Brain ; diagnostic imaging ; pathology ; Brain Edema ; etiology ; pathology ; Child ; Diagnosis, Differential ; Electroencephalography ; Guillain-Barre Syndrome ; complications ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging ; Male ; Posterior Leukoencephalopathy Syndrome ; complications ; diagnosis ; therapy ; Radiography

Autochthonous hepatitis E virus (HEV) is an emerging pathogen in developed countries, and several cases of acute HEV infection have been reported in South Korea. However, there have been no reports on HEV-associated Guillain-Barré syndrome (GBS) in Korea. We recently experienced the case of a 58-year-old Korean male with acute HEV infection after ingesting raw deer meat. Persistent cholestasis was resolved by the administration of prednisolone. At 2.5 months after the clinical presentation of HEV infection, the patient developed weakness of the lower limbs, and was diagnosed with GBS associated with acute hepatitis E. To our knowledge, this is the second report on supportive steroid therapy for persistent cholestasis due to hepatitis E, and the first report of GBS in a Korean patient with acute HEV infection.
Acute Disease ; Alanine Transaminase/blood ; Antibodies, Viral/blood ; Aspartate Aminotransferases/blood ; Bilirubin/analysis ; Cholestasis/*drug therapy ; Guillain-Barre Syndrome/complications/*diagnosis ; Hepatitis E/*diagnosis/etiology ; Hepatitis E virus/immunology ; Humans ; Immunoglobulin M/blood ; Liver/pathology ; Male ; Middle Aged ; Prednisolone/therapeutic use ; Republic of Korea ; Steroids/*therapeutic use