Introduction The hepatitis E virus (HEV) is the leading cause of acute hepatitis around the world. In recent years, knowledge has increased concerning extrahepatic manifestations caused by HEV, including neurological manifestations such as Parsonage-Turner syndrome (PTS). PTS is characterized by severe shoulder or arm pain and patchy paresis with muscle weakness. The aim of the present study was to assess the association between HEV and PTS. Materials and Methods We reported two cases of PTS associated with HEV, which were diagnosed in a short period of time in the same village. PTS was diagnosed by physical examination and electrophysiological studies, and serology testing for IgM, low-avidity IgG, and RNA of HEV established the diagnosis of acute HEV infection. Results A 44-year-old man who presented cervicobrachial pain accompanied by paresthesia, dyspnea, and isolated derangement of liver enzymes and 57-year-old women with cervical pain radiated to upper limbs, paresthesia, and liver cytolysis, although, this patient was initially diagnosed as having drug-induced hepatitis. Finally, the diagnosis was Parsonage- Turner syndrome associated with hepatitis e virus. In both patients, symptoms were bilateral and they required hospital admission. Both consumed vegetables are grown in a local patch and the phylogenetic analysis showed genotype 3f. Then, we reviewed the literature on PTS and HEV and we found 62 previously described cases that were more likely to be men (86.20 %) with more frequent bilateral symptoms (85.71 %). Genotype 3 is the most commonly associated. Three of those cases were diagnosed in Spain. Conclusions According to our findings, HEV should be considered in patients with neuralgic amyotrophy, including those with the absence of liver cytolysis.

简介 戊型肝炎病毒 (HEV) 是全世界急性肝炎的主要原因。近年来，关于 HEV 引起的肝外表现的知识增加，包括神经系统表现，如 Parsonage-Turner 综合征 (PTS)。PTS 的特点是严重的肩部或手臂疼痛和斑片状麻痹伴肌肉无力。本研究的目的是评估 HEV 和 PTS 之间的关联。材料和方法 我们报告了两例与 HEV 相关的 PTS 病例，这些病例是在同一村庄短时间内确诊的。PTS 通过体格检查和电生理学检查确诊，HEV 的 IgM、低亲和力 IgG 和 RNA 的血清学检测确立了急性 HEV 感染的诊断。结果 一名 44 岁男性出现颈臂痛伴感觉异常、呼吸困难和孤立性肝酶紊乱，57 岁女性出现颈痛放射至上肢、感觉异常和肝细胞溶解，尽管该患者是初步诊断为药物性肝炎。最后，诊断为与戊型肝炎病毒相关的 Parsonage-Turner 综合征。在这两名患者中，症状都是双侧的，需要住院。两种食用的蔬菜都生长在当地的斑块中，系统发育分析显示基因型为 3f。然后，我们回顾了有关 PTS 和 HEV 的文献，我们发现 62 例先前描述的病例更可能是男性 (86.20 %)，双侧症状更频繁 (85.71 %)。基因型 3 是最常相关的。其中三例是在西班牙确诊的。结论 根据我们的研究结果，神经痛性肌萎缩患者，包括没有肝细胞溶解的患者，应考虑 HEV。