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