Evidence map›Paper›PMID 39131153›Full record

ArticleFrontiers in immunology2024

Chronic hepatitis E virus-induced spinal cord atrophy in a patient with chronic lymphatic leukemia: a case report and interdisciplinary management proposal.

Marvin Ritter, Olaposi Yomade, Ben-Ole Holtz, Stefanie Deinhardt-Emmer, Aaron Lawson McLean, Stefanie Hartinger, Julia Bechwar, Matthias Schwab, André Huss, Christian Mawrin and 4 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Marvin RitterDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Olaposi YomadeDepartment of Hematology and Medical Oncology, Clinic of Internal Medicine II, Jena University Hospital, Jena, Germany.
Ben-Ole HoltzDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Stefanie Deinhardt-EmmerInstitute of Medical Microbiology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Aaron Lawson McLeanComprehensive Cancer Center Central Germany (CCCG), Jena, Germany.
Stefanie HartingerDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Julia BechwarDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Matthias SchwabDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
André HussDepartment of Neurology, University Hospital of Ulm, Ulm, Germany.
Christian MawrinDepartment of Neuropathology, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Hubertus AxerDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Karin G SchrenkDepartment of Hematology and Medical Oncology, Clinic of Internal Medicine II, Jena University Hospital, Jena, Germany.
Philipp A ReukenDepartment of Gastroenterology, Hepatology, and Infectious Diseases, Clinic of Internal Medicine IV, Jena University Hospital, Jena, Germany.
Irina MäurerDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The hepatitis E virus (HEV) can cause acute viral hepatitis with or without neurological manifestations, and occasionally progresses to chronic infection in immunocompromised individuals. The management of chronic HEV infection in cancer patients may be challenging due to the complex immunological constellation. Furthermore, the diagnostic workflow and the impact on quality of life of neurological HEV manifestations in immunocompromised patients have not been sufficiently delineated previously. Case description: A 61-year-old male with systemically treated chronic lymphocytic leukemia (CLL) experienced a slowly progressive atrophy of the spinal cord due to a chronic HEV infection. Despite continuous antiviral treatment with ribavirin, the patient's neurological condition continued to deteriorate, particularly following subsequent attempts to treat CLL. Treatment with obinutuzumab resulted in acute bowel and urinary retention and a further deterioration of motor skills, prompting the discontinuation of obinutuzumab. The patient's neurological status improved after the administration of intravenous immunoglobulins. Conclusion: This case study provides a comprehensive long-term follow-up of a cancer patient with chronic HEV infection and associated CNS involvement, which resulted in progressive neurological disability over several years. The challenges faced in diagnosing new neurological symptoms in patients undergoing immunosuppressive cancer treatment underscore the need for an interdisciplinary diagnostic approach that includes HEV testing. We propose a diagnostic pathway for future validation in immunocompromised cohorts presenting with neurological symptoms, emphasizing its potential to enhance clinical outcomes.

Indexed as

AtrophyHepatitis ELeukemia, Lymphocytic, Chronic, B-CellAntibodies, Monoclonal, HumanizedAntiviral AgentsChronic DiseaseHepatitis E virusHumansImmunocompromised HostMaleMiddle AgedSpinal CordAntibodies, Monoclonal, HumanizedAntiviral AgentsobinutuzumabcancerHEVlymphomaneurofilamentsneuroinflammationneurological symptoms

Identifiers

PMID39131153
PMCPMC11310032

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.