Rivera RJF, Rodríguez LC

Language: English
References: 22
Page: 36-39
PDF size: 41.22 Kb.

ABSTRACT

Hepatic encephalopathy (HE) is a heterogeneous disease that develops as a result of serious liver disease, such as in fulminant hepatitis or cirrhosis, or a portosystemic shunt. It manifests as a spectrum of abnormalities involving cognition, attention, functional ability, personality and intellect. The neuropsychiatric impairment associated with HE can range from mild alteration of cognition and consciousness to coma, depending on the stage of the illness. In 1998, the World Gastroenterology Organization formed a working party to develop guidelines and recommendations for the diagnosis, grading and treatment of HE for research and practice. In this report, we discuss the various tests available for diagnosis and grading and the recommendations of the working party, which provide a framework for further studies on clinical trial methodology.

REFERENCES

1. Abou-Assi S, Vlahcevic ZR. Hepatic encephalopathy. Metabolic consequence of cirrhosis often is reversible. Postgrad Med 2001; 109(2): 52-4, 57-60, 63-5 passim.

2. Blei AT. Diagnosis and treatment of hepatic encephalopathy. Baillieres Best Pract Res Clin Gastroenterol 2000; 14(6): 959-74.

3. Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT. Hepatic encephalopathy-definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology 2002; 35(3): 716-21.

4. Belanger M, Desjardins P, Chatauret N, Butterworth RF. Loss of expression of glial fibrillary acidic protein in acute hyperammonemia. Neurochem Int 2002; 41(2–3): 155-60.

5. Belanger M, Desjardins P, Chatauret N, Butterworth RF. Selectively increased expression of the astrocytic/endothelial glucose transporter protein GLUT1 in acute liver failure. Glia 2006; 53(5): 557-62.

6. Butterworth RF. Neuronal cell death in hepatic encephalopathy. Metab Brain Dis 2007; 22(3-4): 309-20.

7. Mullen KD. Review of the final report of the 1998 Working Party on definition, nomenclature and diagnosis of hepatic encephalopathy. Aliment Pharmacol Ther 2007; 25(Suppl. 1): 11-6.

8. Gerber T, Schomerus H. Hepatic encephalopathy in liver cirrhosis: pathogenesis, diagnosis and management. Drugs 2000; 60(6): 1353-70.

9. Prakash R, Mullen KD. Mechanisms, diagnosis and management of hepatic encephalopathy. Nat Rev Gastroenterol Hepatol 2010; 7(9): 515-25.

10. Sotil EU, Gottstein J, Ayala E, Randolph C, Blei AT. Impact of preoperative overt hepatic encephalopathy on neurocognitive function after liver transplantation. Liver Transpl 2009; 15(2): 184-92.

11. Mullen KD, Amodio P, Morgan MY. Therapeutic studies in hepatic encephalopathy. Metab Brain Dis 2007; 22(3-4): 407-23.

12. Bajaj JS, Wade JB, Sanyal AJ. Spectrum of neurocognitive impairment in cirrhosis: Implications for the assessment of hepatic encephalopathy. Hepatology 2009; 50(6): 2014-21.

13. Weissenborn K, Ennen JC, Schomerus H, Ruckert N, Hecker H. Neuropsychological characterization of hepatic encephalopathy. J Hepatol 2001; 34(5): 768-73.

14. Romero-Gomez M. Critical flicker frequency: it is time to break down barriers surrounding minimal hepatic encephalopathy. J Hepatol 2007; 47(1): 10-1.

15. Kircheis G, Wettstein M, Timmermann L, Schnitzler A, Haussinger D. Critical flicker frequency for quantification of low-grade hepatic encephalopathy. Hepatology 2002; 35(2): 357-66.

16. Mardini H, Saxby BK, Record CO. Computerized psychometric testing in minimal encephalopathy and modulation by nitrogen challenge and liver transplant. Gastroenterology 2008; 135(5): 1582-90.

17. Bajaj JS, Saeian K, Verber MD, et al. Inhibitory control test is a simple method to diagnose minimal hepatic encephalopathy and predict development of overt hepatic encephalopathy. Am J Gastroenterol 2007; 102(4): 754-60.

18. Bass NM. Review article: the current pharmacological therapies for hepatic encephalopathy. Aliment Pharmacol Ther 2007; 25(Suppl. 1): 23-31.

19. Fanelli F, Salvatori FM, Rabuffi P, et al. Management of refractory hepatic encephalopathy after insertion of TIPS: long-term results of shunt reduction with hourglass-shaped balloon-expandable stent-graft. AJR Am J Roentgenol 2009; 193(6): 1696-702.

20. Alcorn J. Review: rifaximin is equally or more effective than other antibiotics and lactulose for hepatic encephalopathy. ACP J Club 2008; 149(5): 11.

21. Als-Nielsen B, Gluud LL, Gluud C. Nonabsorbable disaccharides for hepatic encephalopathy. Cochrane Database Syst Rev 2004; (2): CD003044.

22. Sharma BC, Sharma P, Agrawal A, Sarin SK. Secondary prophylaxis of hepatic encephalopathy: an open-label randomized controlled trial of lactulose versus placebo. Gastroenterology 2009; 137(3): 885-91: 91e1.