ABSTRACT
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Subject(s)
Humans , Male , Aged , Arthritis , Edema , Muscle Weakness , Rheumatoid Factor , Tenosynovitis , Arthritis/blood , Arthritis/diagnosis , Arthritis/therapy , Edema/blood , Edema/diagnosis , Edema/therapy , Muscle Weakness/blood , Muscle Weakness/diagnosis , Muscle Weakness/therapy , Pelvic Bones , Scapula , Syndrome , Tenosynovitis/blood , Tenosynovitis/diagnosis , Tenosynovitis/therapySubject(s)
Arthritis , Edema , Muscle Weakness , Rheumatoid Factor , Tenosynovitis , Aged , Arthritis/blood , Arthritis/diagnosis , Arthritis/therapy , Edema/blood , Edema/diagnosis , Edema/therapy , Humans , Male , Muscle Weakness/blood , Muscle Weakness/diagnosis , Muscle Weakness/therapy , Pelvic Bones , Scapula , Syndrome , Tenosynovitis/blood , Tenosynovitis/diagnosis , Tenosynovitis/therapyABSTRACT
La encefalopatía hepática crónica o persistente es una complicación que aparece en el 1% de los pacientes con hepatopatía crónica. Presentamos un nuevo caso en una paciente afectada de cirrosis biliar primaria.Mujer de 69 años con cirrosis biliar primaria en estadio IV. Consulta por cuadro progresivo de 6 meses de evolución de fallos mnésicos, temblor y cierta torpeza para caminar. La exploración reveló un tinte subictérico, amnesia reciente, temblor fino distal en miembros superiores bilateral e hiperreflexia generalizada con aumento del área reflexógena.El hemograma mostró discreta pancitopenia, hipertransaminasemia, patrón de colestasis, alargamiento del tiempo de tromboplastina e hipocolinesterasemia. Tras descartar la enfermedad de Wilson se practicó una resonancia magnética craneal en secuencia T1 que mostró hiperintensidad en globo pálido bilateral, que junto a la clínica son compatibles con el diagnóstico.Las hepatopatías crónicas pueden ocasionar una encefalopatía hepática crónica. Los especialistas en digestivo deben conocer esta entidad(AU)
Chronic or persistent hepatic encephalopathy is a complication that develops in 1% of patients with chronic liver disease. We report a new case of this complication in a patient with primary biliary cirrhosis.A 69-year-old woman with stage IV primary biliary cirrhosis presented with a 6-month history of progressive memory deficits, tremors and somewhat clumsy gait. Examination revealed sub-jaundiced skin tone, short-term memory deficits, fine distal bilateral tremor in the upper extremities and generalized hyperreflexia with spread of the reflexogenic zone.The hemogram showed mild pancytopenia, hypertransaminasemia, cholestatic pattern, lengthened thromboplastin time and hypocholinesterasemia. Wilson's disease was excluded and a cranial magnetic resonance imaging scan showed a bilateral hyperintense globus pallidus on T1-weighted sequences, which, together with the symptoms, were compatible with the diagnosis.Chronic liver diseases may cause chronic hepatic encephalopathy. Gastroenterologists should be familiar with this entity(AU)
Subject(s)
Humans , Female , Aged , Hepatic Encephalopathy/complications , Liver Cirrhosis, Biliary/complications , Magnetic Resonance Spectroscopy , Hepatolenticular Degeneration/diagnosis , Diagnosis, DifferentialABSTRACT
Chronic or persistent hepatic encephalopathy is a complication that develops in 1% of patients with chronic liver disease. We report a new case of this complication in a patient with primary biliary cirrhosis. A 69-year-old woman with stage IV primary biliary cirrhosis presented with a 6-month history of progressive memory deficits, tremors and somewhat clumsy gait. Examination revealed sub-jaundiced skin tone, short-term memory deficits, fine distal bilateral tremor in the upper extremities and generalized hyperreflexia with spread of the reflexogenic zone. The hemogram showed mild pancytopenia, hypertransaminasemia, cholestatic pattern, lengthened thromboplastin time and hypocholinesterasemia. Wilson's disease was excluded and a cranial magnetic resonance imaging scan showed a bilateral hyperintense globus pallidus on T1-weighted sequences, which, together with the symptoms, were compatible with the diagnosis. Chronic liver diseases may cause chronic hepatic encephalopathy. Gastroenterologists should be familiar with this entity.
