首页|Bilateral neuralgic amyotrophy in a patient with livestock-associated hepatitis E virus infection
Bilateral neuralgic amyotrophy in a patient with livestock-associated hepatitis E virus infection
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NSTL
Cma-Canadian Medical Assoc
A 52-year-old, previously healthy, right-handed male livestock trader woke in the middle of the night with acute, 9/10 right shoulder and forearm pain. He was unable to go back to sleep because of the pain, despite taking analgesics. The following day, he noticed weakness in his right hand and presented to the emergency department. He was found to have severe right shoulder pain and decreased active range of motion. Hand weakness was not documented. A presumptive diagnosis of inflammatory arthritis was made. Blood work showed normal complete blood count, electrolytes, creatinine kinase and erythrocyte sedimentation rate and elevated hepatic enzymes: aspartate aminotransferase 205 (normal range 16-51) U/L, alanine aminotransferase 472 (normal < 52) U/L, lactate dehydrogenase 861 (normal range 230-490) U/L, γ-glutamyl transferase 442 (normal range 5-38) U/L, and alkaline phosphatase 186 (normal range 36-144) U/L. The elevated hepatic enzymes were felt to be unrelated to the working diagnosis. The patient was prescribed prednisone 50 mg orally daily and analgesics and instructed to follow up with his family physician.
Nicholas J. Miller、Davyd R. Hooper、Aditya Sharma
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Departments of Physical Medicine and Rehabilitation
NSTL
Cma-Canadian Medical Assoc
