Hepatic Encephalopathy Is Not Always due to Liver Cirrhosis
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Hepatic Encephalopathy Is Not Always due to Liver Cirrhosis. / Ecker, Miriam Eva; Paparoupa, Maria; Sostmann, Bernd; Weissenborn, Karin; Schuppert, Frank.
In: CASE REP GASTROENTER, Vol. 16, No. 2, 12.07.2022, p. 313-319.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Hepatic Encephalopathy Is Not Always due to Liver Cirrhosis
AU - Ecker, Miriam Eva
AU - Paparoupa, Maria
AU - Sostmann, Bernd
AU - Weissenborn, Karin
AU - Schuppert, Frank
N1 - Copyright © 2022 by S. Karger AG, Basel.
PY - 2022/7/12
Y1 - 2022/7/12
N2 - Hepatic encephalopathy (HE) is a frequent and debilitating complication of liver disease and is oftentimes associated with hyperammonaemia. However, hyperammonaemia may occur in underlying conditions other than acute or chronic liver failure and clinical awareness is needed in order to be recognized and treated properly. A 24-year-old woman presented herself to our emergency department with acute confusion and altered mental state due to severe hyperammonaemia. The patient was diagnosed in the age of 14 with ornithine transcarbamylase (OTC) deficiency and was incompliant regarding her diet and suggested medication to treat this disorder. She was treated with sodium benzoate 250 mg/kg i.v., sodium phenylbutyrate/sodium phenylacetate 250 mg/kg i.v., L-arginine 250 mg/kg i.v., and received continuous hemofiltration. Under simultaneous medical treatment and haemodialysis, ammonia levels dropped to normal within 24 h and symptomatic encephalopathy ceased completely. OTC deficiency is rare in adults, and the majority of patients are diagnosed in childhood. It can lead to death if not diagnosed and treated properly. Our case underlines the importance of considering causes of HE other than liver cirrhosis.
AB - Hepatic encephalopathy (HE) is a frequent and debilitating complication of liver disease and is oftentimes associated with hyperammonaemia. However, hyperammonaemia may occur in underlying conditions other than acute or chronic liver failure and clinical awareness is needed in order to be recognized and treated properly. A 24-year-old woman presented herself to our emergency department with acute confusion and altered mental state due to severe hyperammonaemia. The patient was diagnosed in the age of 14 with ornithine transcarbamylase (OTC) deficiency and was incompliant regarding her diet and suggested medication to treat this disorder. She was treated with sodium benzoate 250 mg/kg i.v., sodium phenylbutyrate/sodium phenylacetate 250 mg/kg i.v., L-arginine 250 mg/kg i.v., and received continuous hemofiltration. Under simultaneous medical treatment and haemodialysis, ammonia levels dropped to normal within 24 h and symptomatic encephalopathy ceased completely. OTC deficiency is rare in adults, and the majority of patients are diagnosed in childhood. It can lead to death if not diagnosed and treated properly. Our case underlines the importance of considering causes of HE other than liver cirrhosis.
U2 - 10.1159/000524551
DO - 10.1159/000524551
M3 - SCORING: Journal article
C2 - 35814799
VL - 16
SP - 313
EP - 319
JO - CASE REP GASTROENTER
JF - CASE REP GASTROENTER
SN - 1662-0631
IS - 2
ER -