[Pubmed] Acute liver failure due to hepatitis A virus presented with Guillain-Barré syndrome and ocular myasthenia gravi

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BMJ Case Rep. 2023 Oct 9;16(10):e254855. doi: 10.1136/bcr-2023-254855.

ABSTRACT

Hepatitis A is one of the most common causes of acute viral hepatitis in children. Immunological manifestations involving the nervous system are rare with hepatitis A infection. We report a case of a toddler who presented with acute liver failure secondary to hepatitis A infection. The child showed clinical and laboratory improvement initially with conservative management. However, after the initial improvement, she developed acute-onset ptosis along with areflexia. Serological and neurophysiological tests revealed the occurrence of ocular variant Guillain-Barré syndrome and ocular myasthenia gravis, which was only partially responsive to treatment (intravenous immunoglobulin and pyridostigmine). A sudden clinical deterioration was noted after the onset of ptosis. She succumbed on day 40 of hospitalisation due to hospital-acquired infection along with the primary hepatic pathology. This is a rare coincidental presentation of acute viral hepatitis A infection with autoimmune manifestations.

PMID:37813556 | DOI:10.1136/bcr-2023-254855


Source: https://pubmed.ncbi.nlm.nih.gov/3781355 ... t6+86293ac