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Viral neuromyopathy associated with acute hepatitis B infection
  1. Boby Varkey Maramattom1 and
  2. Akheel A Syed2,3
  1. 1Neurology, Aster Medcity, Kochi, Kerala, India
  2. 2Diabetes & Endocrinology, Salford Royal Northern Care Alliance NHS Foundation Trust, Salford, UK
  3. 3Division of Diabetes, Endocrinology & Gastroenterology, The University of Manchester, Manchester, UK
  1. Correspondence to Dr Akheel A Syed; aas{at}


Viral myositis is commonly seen with influenza and COVID-19 infections. While it has been described with acute viral hepatitis, concomitant involvement of the peripheral nerves causing a neuromyopathy has not been reported. A 67-year-old man with acute hepatitis B infection developed a severe myalgia and lower limb weakness around 1 month into his illness. Investigations revealed a neuromyopathy and rhabdomyolysis. MRI whole body with short tau inversion recovery sequences showed scattered muscle hyperintensities in the upper and lower limbs. He was treated with intravenous immunoglobulin and improved. This is the first report of an acute neuromyopathy associated with acute hepatitis B viral infection and demonstration of muscle MRI abnormalities in this condition.

  • hepatitis B
  • neuromuscular disease
  • hepatitis and other gi infections

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  • Contributors BVM was the treating physician and wrote the first draft which was revised by AAS. Both authors revised and approved the submitted version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.