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ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

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Case Report

Hepatic Encephalopathy by Manganese Deposition: A Case Report and a Review of Literature

Author(s): Ludovico Abenavoli*, Giulia Fabiano, Anna Caterina Procopio, Isabella Aquila, Rinaldo Pellicano, Stefania Barone and Maurizio Morelli

Volume 17, Issue 3, 2022

Published on: 01 August, 2022

Page: [216 - 219] Pages: 4

DOI: 10.2174/1574887117666220617104539

Price: $65

Abstract

Background: Hepatic encephalopathy is defined as a spectrum of neuropsychiatric disorders in patients with liver dysfunction, usually cirrhosis, after exclusion of brain disease. This study reports the role of manganese in brain alterations and clinical manifestations of hepatic encephalopathy.

Case presentation: Male patient, 67 years old, suffering from alcoholic liver cirrhosis and two previous episodes of hepatic encephalopathy, developed drowsiness, asterixis, amnesia, disorientation in time and space, and psychomotor retardation. Brain MRI without contrast showed initial signs of cerebral atrophy, a hyperintense signal of globi pallidi and bilateral substantia nigra. The hyperintense signal of globi pallidi is the result of manganese deposition in the brain.

Conclusion: The case report presented supports the data reported in the literature, indicating that the increase in plasma manganese levels in subjects with liver dysfunction is correlated with the onset of extrapyramidal symptoms.

Keywords: Hepatic encephalopathy, Manganese, cirrhosis, liver dysfunction, brain, extrapyramidal symptoms, globi pallidi.

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