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肝移植后患者出现韦尼克脑病:病例报告。

Wernicke encephalopathy in a patient after liver transplantation: A case report.

机构信息

Organ Transplantation Center, The Second Xiang-ya Hospital, Central South University, Changsha 410011, Hunan Province, China.

Department of Neurology, Xiang-ya Hospital, Central South University, Changsha 410008, Hunan Province, China.

出版信息

World J Gastroenterol. 2017 Dec 21;23(47):8432-8436. doi: 10.3748/wjg.v23.i47.8432.

Abstract

Wernicke encephalopathy (WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism and is rare in acute liver failure. So far, there are 2 cases of WE reported after liver transplantation. Here, we report a case of a 45-year-old nonalcoholic male patient who developed psychiatric and neurological disturbance 15 d after receiving orthotopic liver transplantation because of hepatitis B-related cirrhosis and portal hypertension. Brain magnetic resonance imaging (MRI) showed symmetric high-signal intensities in the periaqueductal area. The patient was diagnosed with WE and given intravenous high-dose vitamin B1 immediately. His neurological disturbance resolved in 7 d after receiving the vitamin B1. Brain MRI after 5 mo showed nearly complete recovery. Most WE cases may be misdiagnosed in patients after liver transplantation, and we should pay more attention to its onset.

摘要

威尼克脑病(WE)是一种由维生素 B1 缺乏引起的急性神经障碍,在慢性酒精中毒中很常见,在急性肝功能衰竭中很少见。到目前为止,肝移植后有 2 例 WE 报道。在这里,我们报告了一例 45 岁非酒精性男性患者,他因乙型肝炎相关肝硬化和门静脉高压接受原位肝移植后 15 天出现精神和神经障碍。脑磁共振成像(MRI)显示导水管周围区对称高信号强度。该患者被诊断为 WE,并立即给予静脉内大剂量维生素 B1。他的神经功能障碍在接受维生素 B1 治疗 7 天后得到缓解。5 个月后的脑 MRI 显示几乎完全恢复。大多数 WE 病例可能在肝移植后的患者中被误诊,我们应该更加注意其发病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be70/5743514/0f7946632e77/WJG-23-8432-g001.jpg

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