Hyperammonemia with intermittent loss of consciousness caused by chronic portal-systemic shunt encephalopathy (CPSE) in hemodialysis patient-A case report

美緒, 上田; 智亜里, 小島; 秀和, 杉浦; 隆子, 大貫; 好子, 田中; 亜由子, 藤生; 基文, 鈴木; 彰仁, 三宮; 孝作, 新田; 隆, 秋葉

doi:10.4009/jsdt.40.445

Cited by 7 publications

(2 citation statements)

References 9 publications

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“…We reviewed 13 cases of HRPSE (Table) (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Of these patients, nine were women and the average patient age was 62.2 years (range, 32-80 years).…”

Section: Discussionmentioning

confidence: 99%

Hemodialysis-related Portal-Systemic Encephalopathy

et al. 2015

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Hemodialysis-related portal-systemic encephalopathy (HRPSE) is characterized by the presence of portosystemic encephalopathy without liver dysfunction, usually caused by changes in the systemic venous flow related to hemodialysis. We herein describe the case of a 75-year-old woman who developed hepatic encephalopathy five years after the initiation of hemodialysis. Abdominal contrast-enhanced computed tomography (CT) and three-dimensional CT angiography revealed a portosystemic venous shunt, and the patient was diagnosed with portosystemic encephalopathy. Occlusion therapy ameliorated her disturbance of consciousness. HRPSE should be recognized as a treatable neuropsychiatric disorder.

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“…We reviewed 13 cases of HRPSE (Table) (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Of these patients, nine were women and the average patient age was 62.2 years (range, 32-80 years).…”

Section: Discussionmentioning

confidence: 99%

Hemodialysis-related Portal-Systemic Encephalopathy

et al. 2015

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“…Portal-systemic encephalopathy without portal hypertension by an IMV–internal iliac vein shunt in a patient undergoing HD following unsuccessful PD is a very rare [ 1 – 3 ]. Our case may have a congenital portal-systemic venous shunt, since the shunt vessel was single and he did not have liver dysfunction and/or portal hypertension [ 4 ].…”

mentioning

confidence: 99%

A dialysis patient with hyperammonaemia: inferior mesenteric-caval shunt as a cause of portal-systemic encephalopathy

Izumiya-Iwai

Isshiki

Chin‐Kanasaki

et al. 2011

Clinical Kidney Journal

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Hemodiafiltration for hepatic encephalopathy induced by Budd–Chiari syndrome in a patient with end-stage kidney disease

et al. 2015

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A 36-year-old woman who was undergoing dialysis for end-stage kidney disease (ESKD) was admitted to our hospital with consciousness disorder. She was diagnosed with Budd-Chiari syndrome due to antiphospholipid syndrome at the age of 28 years. Her kidney function and leg edema gradually deteriorated. After initiation of hemodialysis (HD), transient loss of consciousness due to hepatic encephalopathy during HD treatment occurred frequently. Her kidney replacement therapy was changed to online hemodiafiltration (HDF), which dramatically improved her hepatic coma. Compared with HD, HDF contributed to the increase in Fischer's ratio and decrease in tryptophan level, which has a high protein-bound property. This case suggests that HDF may be beneficial for hepatic encephalopathy in ESKD patients by modulating the amino acid profile.

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Hyperammonemia with intermittent loss of consciousness caused by chronic portal-systemic shunt encephalopathy (CPSE) in hemodialysis patient-A case report

Cited by 7 publications

References 9 publications

Hemodialysis-related Portal-Systemic Encephalopathy

Hemodialysis-related Portal-Systemic Encephalopathy

A dialysis patient with hyperammonaemia: inferior mesenteric-caval shunt as a cause of portal-systemic encephalopathy

Hemodiafiltration for hepatic encephalopathy induced by Budd–Chiari syndrome in a patient with end-stage kidney disease

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