Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 7, 2009; 15(13): 1645-1647
Published online Apr 7, 2009. doi: 10.3748/wjg.15.1645
Guillain-Barré syndrome following hepatitis E
Jean Philippe Loly, Estelle Rikir, Maxime Seivert, Emile Legros, Pierre Defrance, Jacques Belaiche, Gustave Moonen, Jean Delwaide
Jean Philippe Loly, Maxime Seivert, Jacques Belaiche, Jean Delwaide, Department of Hepato-Gastroenterology, CHU Sart Tilman, Université de Liège, 4000 Liège, Belgium
Estelle Rikir, Gustave Moonen, Department of Neurology, CHU Sart Tilman, Université de Liège, 4000 Liège, Belgium
Emile Legros, General Practitioner, rue Neuve, 144, 4860 Pepinster, Verviers, Belgium
Pierre Defrance, Department of Hepato-Gastroenterology, CHPLT La Tourelle, 4800 Verviers, Belgium
Author contributions: Loly JP, Rikir E, Seivert M, Moonen G, Delwaide J wrote the manuscript; Legros E and Defrance P provided the relevant clinical data; Belaiche J contributed to the discussion and reviewed the manuscript.
Correspondence to: Jean Delwaide, Department of Hepato-Gastroenterology, CHU Sart Tilman, Université de Liège, 4000 Liège, Belgium. jean.delwaide@chu.ulg.ac.be
Telephone: +32-4-3667256
Fax: +32-4-3667889
Received: September 26, 2008
Revised: February 25, 2009
Accepted: March 4, 2009
Published online: April 7, 2009
Abstract

Guillain-Barré syndrome (GBS) is often triggered by a preceding bacterial or viral infection. Occasionally, it has been observed in association with acute hepatitis A, B and C, and three cases have been previously described in India in which GBS was associated with acute hepatitis E. A molecular mimicry mechanism is supposed to be involved in the pathogenesis of GBS triggered by infectious agents, although the nature of the shared epitopes has not been characterized in most instances, including that in the case of hepatotropic viruses. We report a case of GBS following acute hepatitis E in a European individual. The presence of antiganglioside GM2 antibodies in this patient suggested molecular mimicry involving ganglioside GM2 in the pathogenesis of GBS associated with hepatitis E.

Keywords: Gangliosides; Guillain-Barré syndrome; Hepatitis E; Molecular mimicry; Viral hepatitis