scholarly journals Metronidazole-Induced Encephalopathy in a Patient with End-Stage Liver Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
John P. Knorr ◽  
Imran Javed ◽  
Neha Sahni ◽  
Ceylan Z. Cankurtaran ◽  
Jorge A. Ortiz
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Corpus Callosum ◽  
Diffusion Restriction ◽  
End Stage Liver Disease ◽  
Short Course ◽  
Liver Transplant Waiting List ◽  
End Stage ◽  
Inferior Colliculi

Purpose. Metronidazole-induced encephalopathy (MIE) has been rarely reported. We report a case in a patient with end-stage liver disease (ESLD).Summary. A 63-year-old male with ESLD secondary to hepatitis C virus presented with progressively worsening fatigue, slurred speech, aphasia, vomiting, and left-sided facial droop after completing a 2-week course of metronidazole for recurrentClostridium difficile-associated diarrhea. He completed a previous course of metronidazole 3 weeks prior to presentation. He is on the liver transplant waiting list and has known hepatic encephalopathy. MRI revealed hyperintense T2 signals involving the bilateral dentate nuclei, inferior colliculi and splenium of the corpus callosum, and increased diffusion restriction at the splenium of the corpus callosum. His neurological function improved over the next several days. He underwent liver transplantation 6 days after admission. A follow-up MRI 6 weeks after presentation revealed resolution of abnormalities; however, paresthesias persisted 6 months after MIE diagnosis.Conclusion. An ESLD patient with hepatic encephalopathy developed MIE after a relatively short course of metronidazole. Metronidazole has been shown to accumulate in patients with ESLD. Increased awareness for neurotoxicity when using metronidazole in ESLD patients is warranted, especially in those with potentially confounding hepatic encephalopathy.

scholarly journals Palliative Care for Patients with End-Stage Liver Disease on the Liver Transplant Waiting List: An International Systematic Review

2021 ◽  
Author(s):  
Shan Shan Vijeratnam ◽  
Bridget Candy ◽  
Rachel Craig ◽  
Aileen Marshall ◽  
Patrick Stone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Liver Disease ◽  
Liver Transplant ◽  
Waiting List ◽  
End Stage Liver Disease ◽  
Liver Transplant Waiting List ◽  
End Stage

scholarly journals Hepatic encephalopathy expands the predictivity of model for end-stage liver disease in liver transplant setting: Evidence by means of 2 independent cohorts

2016 ◽  
Vol 22 (10) ◽  
pp. 1333-1342 ◽  
Author(s):  
Cristina Lucidi ◽  
Stefano Ginanni Corradini ◽  
Juan G. Abraldes ◽  
Manuela Merli ◽  
Puneeta Tandon ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Liver Transplant ◽  
End Stage Liver Disease ◽  
End Stage

Which treatment is best for hepatic encephalopathy due to end-stage liver disease?

2017 ◽  
Vol 20 (5) ◽  
pp. E4-E5
Author(s):  
Danette Null ◽  
Jessica Langevin ◽  
Jason Hagen
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Profound Shock from Metformin-Induced Lactic Acidosis in a Patient with End Stage Liver Disease and Hepatic Encephalopathy

2020 ◽  
Author(s):  
D. Yee ◽  
R. Cangemi ◽  
B. Osler ◽  
K.E. Cox ◽  
Y. Vayntrub ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Lactic Acidosis ◽  
End Stage Liver Disease ◽  
End Stage

Groin Herniorrhaphy in Patients with Cirrhosis and after Liver Transplantation

2009 ◽  
Vol 75 (10) ◽  
pp. 962-965
Author(s):  
Elise H. Lawson ◽  
Elizabeth Benjamin ◽  
Ronald W. Busuttil ◽  
Jonathan R. Hiatt
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
International Normalized Ratio ◽  
Wound Complications ◽  
End Stage Liver Disease ◽  
Proper Patient Selection ◽  
Cirrhotic Patients ◽  
End Stage ◽  
Cirrhotic Group

We report on 43 groin herniorrhaphy operations, 18 in 18 patients with documented cirrhosis and 25 in 24 patients after liver transplantation (LT), over a 10-year period at UCLA. Average follow up was 33 months. Most patients were males (84%) with reducible inguinal hernias (70%). Child's class of cirrhotic patients was B in 66 per cent and A and C in 17 per cent each; 7 patients (39%) went on to LT. Compared with post-LT patients, patients with cirrhosis had significantly lower platelets and significantly higher bilirubin, international normalized ratio, and Model for End-stage Liver Disease scores. Mesh was used in 33 per cent of the cirrhotic group and 48 per cent of the LT group. There were four minor wound complications but no deaths, major complications, infections, or ascitic leaks in either group. Two hernias recurred in the cirrhosis group (11%) and none after LT. We conclude that with proper patient selection, groin herniorrhaphy with or without mesh is a safe and durable procedure in patients with cirrhosis and after LT. This is the first large series of groin herniorrhaphy after LT.

High Model for End-Stage Liver Disease Score as a Predictor of Survival During Long-Term Follow-up After Liver Transplantation

2012 ◽  
Vol 44 (2) ◽  
pp. 384-388 ◽  
Author(s):  
H. Suzuki ◽  
A.S.R. Bartlett ◽  
P. Muiesan ◽  
W. Jassem ◽  
M. Rela ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Disease Score ◽  
End Stage Liver Disease ◽  
Long Term Follow Up ◽  
End Stage

scholarly journals The Model for End-Stage Liver Disease Score and the Follow-Up Period Can Cause the Shift of Circulating Lymphocyte Subsets in Liver Transplant Recipients

2022 ◽  
Vol 8 ◽  
Author(s):  
Fei Pan ◽  
Shuang Cao ◽  
Xian-Liang Li ◽  
Ya-nan Jia ◽  
Ruo-lin Wang ◽  
...  
Keyword(s):  
Liver Disease ◽  
T Cell ◽  
Lymphocyte Subsets ◽  
T Cell Subsets ◽  
Disease Score ◽  
End Stage Liver Disease ◽  
Long Term Follow Up ◽  
The Absolute ◽  
End Stage

Little is known about the shift of lymphocytes under the condition of the model for end-stage liver disease score and the follow-up period. Then, we detected the peripheral blood from liver transplant recipients by flow cytometry and compared the results. The model for end-stage liver disease score affected the percentages of T-cell subsets and B cells during the short-term follow-up period, but failed to influence the lymphocyte subsets during the long-term follow-up period. In contrast, the follow-up period not only affected the absolute counts of T-cell subsets and natural killer (NK) cells in patients with the low model for end-stage liver disease scores, but also influenced the percentages and absolute counts of T-cell subsets in patients with the high model for end-stage liver disease scores. In the two-way ANOVA, we further revealed that the model for end-stage liver disease score was associated with the percentages of T cells and CD4+ T cells and the absolute numbers of T-cell subsets and B cells, while the follow-up period was associated with the percentages of T-cell subsets and the absolute numbers of lymphocyte subsets. Therefore, patients with either the low model for end-stage liver disease scores or the long-term follow-up period are in a relatively activated immune condition.

scholarly journals Assessing the Prognostic Performance of the Child-Pugh, Model for End-Stage Liver Disease, and Albumin-Bilirubin Scores in Patients with Decompensated Cirrhosis: A Large Asian Cohort from Gastroenterology Department

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Si-Zhe Wan ◽  
Yuan Nie ◽  
Yue Zhang ◽  
Cong Liu ◽  
Xuan Zhu
Keyword(s):  
Liver Disease ◽  
Roc Curve ◽  
Meld Score ◽  
The Other ◽  
Decompensated Cirrhosis ◽  
Short Term ◽  
End Stage Liver Disease ◽  
End Stage

Background and Aim. Various methods, including the Child-Pugh score, the model for end-stage liver disease (MELD) score, the MELD combined with serum sodium concentration (MELD-Na) score, the integrated MELD (iMELD) score, and the albumin-bilirubin (ALBI) score, have been widely used for predicting the survival of decompensated cirrhosis (DeCi) patients. In this study, we defined and compared the prognostic value of these scores to predict mortality in DeCi patients. Methods. We performed a single-center, observational retrospective study and analyzed 456 DeCi patients who were hospitalized in the gastroenterology department. The biochemical examination results and demographic characteristics of the patients were obtained, and five scores were calculated upon admission after 24 hours. All patients were observed until death, loss to follow-up, or specific follow-up times (28 days, 90 days, and 6 months). A receiver operating characteristic (ROC) curve was used to evaluate the ability of these methods to predict mortality in DeCi patients. Results. At 28 days, 90 days, and 6 months, the cumulative number of deaths was 50 (11.0%), 76 (16.6%), and 91 (19.9%), respectively. The scores were significantly higher in nonsurviving patients than in surviving patients. All scores yielded viable values in predicting 28-day, 90-day, and 6-month prognoses for DeCi patients. The areas under the ROC curve (AUROCs) of the ALBI score were higher than those of the other scores, which were only over 0.700 at 28 days. The AUROC of the MELD score was higher than that of the other scores, including the MELD-Na and iMELD scores, at 90 days and 6 months. Conclusion. All five methods (Child-Pugh score, MELD score, MELD-Na score, iMELD score, and ALBI score) provided a reliable prediction of mortality for both the short-term and long-term prognosis of patients with DeCi. The ALBI score may be particularly useful for assessing short-term outcomes, whereas the MELD score may be particularly useful for assessing long-term outcomes.

The additive value of sarcopenia, myosteatosis and hepatic encephalopathy in the predictivity of model for end-stage liver disease

2019 ◽  
Vol 51 (11) ◽  
pp. 1508-1512 ◽  
Author(s):  
Barbara Lattanzi ◽  
Silvia Nardelli ◽  
Alessandra Pigliacelli ◽  
Simone Di Cola ◽  
Alessio Farcomeni ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
End Stage Liver Disease ◽  
End Stage
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