Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy

“…Zn deficiency has been related to the pathogenesis of hepatic encephalopathy [145,146]. In a patient with severe recurrent hepatic encephalopathy, artificially induced Zn deficiency provoked an episode of overt encephalopathy, identical to earlier episodes that subsided after oral Zn treatment [147].…”

Section: Correlations Between the Clinical Manifestations Of Zn Deficmentioning

confidence: 99%

Zinc and the Liver: An Active Interaction

2007

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Zinc is an essential trace element, exerting important antioxidant, anti-inflammatory, and antiapoptotic effects. It affects growth and development and participates in processes such as aging and cancer induction. The liver is important for the regulation of zinc homeostasis, while zinc is necessary for proper liver function. Decreased zinc levels have been implicated in both acute and chronic liver disease states, and zinc deficiency has been implicated in the pathogenesis of liver diseases. Zinc supplementation offers protection in experimental animal models of acute and chronic liver injury, but these hepatoprotective properties have not been fully elucidated. In the present review, data on zinc homeostasis, its implication in the pathogenesis of liver diseases, and its effect on acute and chronic liver diseases are presented. It is concluded that zinc could protect against liver diseases, although up to now the underlying pathophysiology of zinc and liver interactions have not been defined.

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“…This has since been re-named as Covert Hepatic Encephalopathy (CHE) (Bajaj et al 2011). CHE is currently regarded as a stage preceding overt HE rather than a separate phenomenon, with the same pathogenesis (Groeneweg et al 1998;Romero-Gomez et al 2001;Stewart and Smith 2007;Yen and Liaw 1990): liver dysfunction, allowing nitrogenous compounds such as ammonia to accumulate centrally, resulting in impaired neurotransmission and cerebral oedema (Häussinger and Schliess 2008).…”

Section: Introductionmentioning

confidence: 99%

Using saccades to diagnose covert hepatic encephalopathy

et al. 2015

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Covert Hepatic Encephalopathy (CHE), previously known as Minimal Hepatic Encephalopathy, is a subtle cognitive defect found in 30-70 % of cirrhosis patients. It has been linked to poor quality of life, impaired fitness to drive, and increased mortality: treatment is possible. Despite its clinical significance, diagnosis relies on psychometric tests that have proved unsuitable for use in a clinical setting. We investigated whether measurement of saccadic latency distributions might be a viable alternative. We collected data on 35 cirrhosis patients at Addenbrooke's Hospital, Cambridge, with no evidence of clinically overt encephalopathy, and 36 age-matched healthy controls. Performance on standard psychometric tests was evaluated to determine those patients with CHE as defined by the World Congress of Gastroenterology. We then compared visually-evoked saccades between those with CHE and those without, as well as reviewing blood test results and correlating saccadic latencies with biochemical parameters and prognostic scores. Cirrhosis patients have significantly longer median saccadic latencies than healthy controls. Those with CHE had significantly prolonged saccadic latencies when compared with those without CHE. Analysis of a cirrhosis patient's saccades can diagnose CHE with a sensitivity of 75 % and a specificity of 75 %. We concluded that analysis of a cirrhosis patient's saccadic latency distributions is a fast and objective measure that can be used as a diagnostic tool for CHE. This improved early diagnosis could direct avoidance of high-risk activities such as driving, and better inform treatment strategies.

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Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy

Cited by 328 publications

References 29 publications

Diagnosis and Prognostic Significance of Minimal Hepatic Encephalopathy in Patients with Cirrhosis of Liver

Diagnosis and Prognostic Significance of Minimal Hepatic Encephalopathy in Patients with Cirrhosis of Liver

Zinc and the Liver: An Active Interaction

Using saccades to diagnose covert hepatic encephalopathy

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