Severe recurrent hepatic encephalopathy that responded to oral branched chain amino acids

Naga Chalasani, Norman Gitlin

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Hepatic encephalopathy is a neuropsychiatric syndrome occurring in patients with acute or chronic liver disease. Its pathogenesis remains unclear; however, it appears to be multifactorial. There are several conventional treatments for this condition, such as lactulose, neomycin, and protein restriction. There is significant controversy regarding the role of branched chain amino acids in the treatment of chronic hepatic encephalopathy. We describe a patient who had hepatic encephalopathy secondary to Budd-Chairi syndrome and a mesoatrial shunt that failed vigorous conventional therapy. She required multiple hospitalizations for severe recurrent encephalopathy. The patient was considered for a colonic exclusion procedure for the management of intractable encephalopathy. However, branched amino acid therapy was instituted as a last measure before the contemplated surgery, and the patient's encephalopathy responded in dramatic fashion, and she remained free from encephalopathy during a prolonged follow-up.

Original languageEnglish (US)
Pages (from-to)1266-1268
Number of pages3
JournalAmerican Journal of Gastroenterology
Volume91
Issue number6
StatePublished - Jun 1996
Externally publishedYes

Fingerprint

Branched Chain Amino Acids
Hepatic Encephalopathy
Brain Diseases
Chronic Brain Damage
Lactulose
Neomycin
Therapeutics
Liver Diseases
Hospitalization
Chronic Disease
Amino Acids
Proteins

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Severe recurrent hepatic encephalopathy that responded to oral branched chain amino acids. / Chalasani, Naga; Gitlin, Norman.

In: American Journal of Gastroenterology, Vol. 91, No. 6, 06.1996, p. 1266-1268.

Research output: Contribution to journalArticle

@article{e3b4faaf76c243f88baa4b605c58ccfe,
title = "Severe recurrent hepatic encephalopathy that responded to oral branched chain amino acids",
abstract = "Hepatic encephalopathy is a neuropsychiatric syndrome occurring in patients with acute or chronic liver disease. Its pathogenesis remains unclear; however, it appears to be multifactorial. There are several conventional treatments for this condition, such as lactulose, neomycin, and protein restriction. There is significant controversy regarding the role of branched chain amino acids in the treatment of chronic hepatic encephalopathy. We describe a patient who had hepatic encephalopathy secondary to Budd-Chairi syndrome and a mesoatrial shunt that failed vigorous conventional therapy. She required multiple hospitalizations for severe recurrent encephalopathy. The patient was considered for a colonic exclusion procedure for the management of intractable encephalopathy. However, branched amino acid therapy was instituted as a last measure before the contemplated surgery, and the patient's encephalopathy responded in dramatic fashion, and she remained free from encephalopathy during a prolonged follow-up.",
author = "Naga Chalasani and Norman Gitlin",
year = "1996",
month = "6",
language = "English (US)",
volume = "91",
pages = "1266--1268",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "6",

}

TY - JOUR

T1 - Severe recurrent hepatic encephalopathy that responded to oral branched chain amino acids

AU - Chalasani, Naga

AU - Gitlin, Norman

PY - 1996/6

Y1 - 1996/6

N2 - Hepatic encephalopathy is a neuropsychiatric syndrome occurring in patients with acute or chronic liver disease. Its pathogenesis remains unclear; however, it appears to be multifactorial. There are several conventional treatments for this condition, such as lactulose, neomycin, and protein restriction. There is significant controversy regarding the role of branched chain amino acids in the treatment of chronic hepatic encephalopathy. We describe a patient who had hepatic encephalopathy secondary to Budd-Chairi syndrome and a mesoatrial shunt that failed vigorous conventional therapy. She required multiple hospitalizations for severe recurrent encephalopathy. The patient was considered for a colonic exclusion procedure for the management of intractable encephalopathy. However, branched amino acid therapy was instituted as a last measure before the contemplated surgery, and the patient's encephalopathy responded in dramatic fashion, and she remained free from encephalopathy during a prolonged follow-up.

AB - Hepatic encephalopathy is a neuropsychiatric syndrome occurring in patients with acute or chronic liver disease. Its pathogenesis remains unclear; however, it appears to be multifactorial. There are several conventional treatments for this condition, such as lactulose, neomycin, and protein restriction. There is significant controversy regarding the role of branched chain amino acids in the treatment of chronic hepatic encephalopathy. We describe a patient who had hepatic encephalopathy secondary to Budd-Chairi syndrome and a mesoatrial shunt that failed vigorous conventional therapy. She required multiple hospitalizations for severe recurrent encephalopathy. The patient was considered for a colonic exclusion procedure for the management of intractable encephalopathy. However, branched amino acid therapy was instituted as a last measure before the contemplated surgery, and the patient's encephalopathy responded in dramatic fashion, and she remained free from encephalopathy during a prolonged follow-up.

UR - http://www.scopus.com/inward/record.url?scp=0030006427&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030006427&partnerID=8YFLogxK

M3 - Article

VL - 91

SP - 1266

EP - 1268

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 6

ER -