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Transverse myelitis caused by hepatitis E: previously undescribed in adults
  1. Pamela Sarkar1,
  2. Catherine Morgan1,
  3. Samreen Ijaz2
  1. 1Department of Neurology, Southmead Hospital, Bristol, UK
  2. 2Public Health England, London, UK
  1. Correspondence to Dr Pamela Sarkar, pam524sarkar{at}


We report the case of a 62-year-old Caucasian woman who was admitted with urinary retention and lower limb paraesthesia following a week's prodromal illness of headache and malaise. Liver function tests showed a picture of acute hepatocellular dysfunction. She developed reduced lower limb power, brisk reflexes, extensor plantars, a sensory level at T8 and reduced anal sphincter tone, establishing a clinical diagnosis of transverse myelitis. A spinal MRI showed no evidence of cauda equina or spinal cord compression. Cerebrospinal fluid (CSF) analysis showed raised protein and raised white cell count. Hepatitis E IgM and IgG were positive and hepatitis E virus was found in her CSF. She was treated with methylprednisolone and is slowly recovering with physiotherapy.

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