{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:48:43Z","timestamp":1791521323861,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"11-12","license":[{"start":{"date-parts":[[2014,10,10]],"date-time":"2014-10-10T00:00:00Z","timestamp":1412899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Autochthonous (locally acquired) hepatitis E is increasingly recognised in developed countries, and is thought to be a porcine zoonosis. A range of extra\u2010hepatic manifestations of hepatitis E infection have been described, but have never been systematically studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To report the extra\u2010hepatic manifestations of hepatitis E virus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of data of 106 cases of autochthonous hepatitis E (acute<jats:italic>n<\/jats:italic>\u00a0=\u00a0105, chronic<jats:italic>n<\/jats:italic>\u00a0=\u00a01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight (7.5%) cases presented with neurological syndromes, which included brachial neuritis, Guillain\u2010Barr\u00e9 syndrome, peripheral neuropathy, neuromyopathy and vestibular neuritis. Patients with neurological syndromes were younger (median age 40\u00a0years, range 34\u201392\u00a0years,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.048) and had a more modest transaminitis (median<jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content>471\u00a0IU\/L,<jats:italic>P\u00a0<\/jats:italic>=\u00a00.015) compared to cases without neurological symptoms [median age 64\u00a0years (range 18\u201388\u00a0years), median<jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content>1135\u00a0IU\/L]. One patient presented with a cardiac arrhythmia,twelve patients (11.3%) presented with thrombocytopenia, fourteen (13.2%) with lymphocytosis and eight (7.5%) with a lymphopenia, none of which had any clinical consequence. Serum electrophoresis was performed in 65 patients at presentation, of whom 17 (26%) had a monoclonal gammopathy of uncertain significance. Two cases developed haematological malignancies, acute myeloid leukaemia and duodenal plasmacytoma, 18 and 36\u00a0months after presenting with acute hepatitis E infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A range of extra\u2010hepatic manifestations can occur with hepatitis E. Neurological and haematological features of hepatitis E infection are relatively frequent in this<jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>cohort, and result in significant morbidity which warrants further study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.12986","type":"journal-article","created":{"date-parts":[[2014,10,10]],"date-time":"2014-10-10T04:41:24Z","timestamp":1412916084000},"page":"1282-1291","source":"Crossref","is-referenced-by-count":140,"title":["Extra\u2010hepatic manifestations of autochthonous hepatitis E infection"],"prefix":"10.1111","volume":"40","author":[{"given":"K. 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G.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Cornwall Gastrointestinal Unit Royal Cornwall Hospital Truro Cornwall UK"},{"name":"European Centre for Environment &amp; Human Health Peninsula College of Medicine &amp; Dentistry University of Exeter Truro UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. G.","family":"Madden","sequence":"additional","affiliation":[{"name":"Cornwall Gastrointestinal Unit Royal Cornwall Hospital Truro Cornwall UK"},{"name":"European Centre for Environment &amp; Human Health Peninsula College of Medicine &amp; Dentistry University of Exeter Truro UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Glasgow","sequence":"additional","affiliation":[{"name":"Cornwall Gastrointestinal Unit Royal Cornwall Hospital Truro Cornwall UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kotecha","sequence":"additional","affiliation":[{"name":"Cornwall Gastrointestinal Unit Royal Cornwall Hospital Truro Cornwall UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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