Case ReviewNeuralgic Amyotrophy Associated With Hepatitis E Virus Infection: First Case in the United StatesAvila, Jose D. MD*,†; Lacomis, David MD†; Lam, Erek M. MD†Author Information *Department of Neurology, Washington University School of Medicine, St. Louis, MO; and †Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA. Reprints: Jose D. Avila, MD, Neuromuscular Division, Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO 63110 (e-mail: [email protected]). Presented in poster form at the 62nd annual meeting of the American Association of Neuromuscular and Electrodiagnostic Medicine, October 29–31, 2015, Honolulu, Hawaii. The authors report no conflicts of interest. Journal of Clinical Neuromuscular Disease: December 2016 - Volume 18 - Issue 2 - p 96-100 doi: 10.1097/CND.0000000000000137 Buy Metrics Abstract Hepatitis E is an emerging viral infection in developed countries. It can present with multiple extra-hepatic manifestations, including neuralgic amyotrophy. We report a 52-year-old man who presented with neck and shoulder pain followed by orthopnea and left arm weakness. Electrodiagnostic testing showed left phrenic neuropathy and denervation in bilateral C5 and C6 myotomes. He also had elevated liver enzymes, which led to the diagnosis of acute hepatitis E. This is the first case of neuralgic amyotrophy associated with hepatitis E in the United States. Hepatitis E should be considered in patients with neuralgic amyotrophy, particularly men with bilateral symptoms, and if there is unexplained elevation of transaminases. The role of antiviral therapy remains unclear. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.