Problems in other parts of the body with hepatitis E
There is now some evidence that hepatitis E can cause problems in other parts of your body, as well as in your liver. These problems are called “extrahepatic manifestations”.
The information on this page is for:
- Adults with Hepatitis E or suspected Hepatitis E
- Family, friends, carers, and healthcare professionals.
These problems are very rare. For some of them there have only been a few known cases in the world.They usually affect people who are not immunosuppressed. But there have also been some cases in people who are immunosuppressed and have acute or chronic hepatitis E.
Because these conditions are so rare, it is not clear for all of them if hepatitis E actually causes them. But there seems to be a link.
These problems are most often found to affect nerves, kidneys or blood.
You can find basic information about the most common ones on this page. There are also links to the NHS website for more information.
Speak to your doctor if you have or have recently had hepatitis E and you have any symptoms of these problems.
On this page:
Nerve problems
Neuralgic amyotrophy
Neuralgic amyotrophy is caused by damage to a group of nerves called the brachial plexus. These nerves are in your neck and shoulders.
Symptoms include:
- Pain, usually in both of your shoulders
- Difficulty moving your arms or hands
- Pins and needles in your arms or hands
- Numbness in your arms or hands
Neuralgic amyotrophy is a type of peripheral neuropathy. You can find out more from the NHS website here
Guillian-Barre Syndrome
Say ghee-yan bar-ray
Guillian-Barre syndrome affects nerves. You usually feel the symptoms in your hands and feet first. They then spread to your arms and legs. Symptoms in your limbs, hands and feet include:
- Feeling numb
- Pain
- Pins and needles
- Weakness
You might also have problems with balance or co-ordination. In very severe cases it can be hard to walk, and people can have difficulty breathing or swallowing. So it is very important to seek medical help if you think you could have Guillian-Barre syndrome.
Encephalitis and myelitis
Encephalitis is inflammation of the brain. Myelitis is inflammation of the spinal cord. These are extremely rare following hepatitis E. But they can be very serious.
Early symptoms include:
- Headache
- Feeling like you have the flu.
These can move on to more serious symptoms including difficulty speaking, confusion, and not being able to move parts of your body.
You can find out more about encephalitis on the NHS page here.
The NHS page also has a longer list of serious symptoms. If you have any of these serious symptoms you should call 999 or go to a hospital straight away.
Bell’s Palsy
Bell’s Palsy can make one side of your face weak and hard to move. It can be treated and most people will get better in a few months.
If your face droops on one side call 999. The drooping could be caused by Bell’s Palsy, but it is also a sign of a stroke. So it is important that you get medical help straight away.
Kidney problems
In a small number of cases, hepatitis E can stop your kidneys working properly.
Hepatitis E has been shown to cause a condition called glomerulonephritis. This can be very mild and might only be found if you are having blood or urine tests.
In more serious cases you might have symptoms including:
- Blood in your urine
- Pain in your joints
- Feeling tired
- Feeling out of breath.
If you get these symptoms you should see your doctor.
You can find out more about glomerulonephritis on the NHS page here.
Blood problems
Some people with hepatitis E can develop a blood problem called thrombocytopenia. This is very rare but it can be serious.
Thrombocytopenia happens when there are not enough platelets in your blood. Platelets are tiny fragments of blood cells. They are very important for stopping bleeding.
The symptoms of thrombocytopenia include:
- Nosebleeds
- Bleeding gums
- Bleeding that lasts longer than usual, even from very small injuries
- Heavy periods
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This content was last reviewed: November 2023
Our expert reviewers:
We would like to thank everyone who helped with creating and reviewing this page. Including Professor Stephen Ryder, consultant hepatologist at Nottingham University Hospitals NHS trust and Dr Ahmed Elsharkawy, consultant hepatologist. And all our patient reviewers.
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Everyone’s experience of liver disease will be different. Always talk to your specialist medical team for personal advice.
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