Öz
Hepatic encephalopathy (HE) is a neuropsychiatric syndrome of patients with chronic liver disease. In addition to ammonia levels, increased manganese levels in the brain are also considered as having role in the pathogenesis of HE. On cranial T1-weighted magnetic resonance imaging (MRI), hyperintense and symmetrical globus pallidi linked to the manganese deposition are characteristic for patients with cirrhosis of the liver. We presented here a case of portal-systemic encephalopathy demonstrated with typical MR images and increased blood manganese concentra-tion.
Anahtar Kelimeler
Kaynakça
- Spahr L, Butterworth RF, Fontaine S, et al. Increased blood manganese in cirrhotic patients: relationship to pallidal magnetic resonance signal hyperintensity and neurological symptoms. Hepatology 1996;24(5):1116-20.
- Riordan S.M, Williams R. Treatment of hepatic encephalopa- thy. N Engl J Med 1997;337 (7):473-9.
- Choi Y, Park JK, Park NH, et al. Whole blood and red blood cell manganese reflected signal intensities of T1-weighted magnetic resonance images better than plasma manganese in liver cirrhotics. J Occup Health 2005;47(1):68-73.
- Hauser RA, Zesiewicz TA, Rosemurgy AS, Martinez C, Ola- now CW. Manganese intoxication and chronic liver failure. Ann Neurol 1994;36(6):871-5.
- Krieger D. Manganese may be of importance in the patho- genesis of chronic hepatic encephalopathy. Biomed Phar- macotherapy 1996;50(2):93-6.
- Gospe SM Jr, Caruso RD, Clegg MS, et al. Paraparesis, hy- permanganesaemia, and polycythaemia: a novel presenta- tion of cirrhosis. Arch Dis Child 2000;83(5):439-42.
- Rose C, Butterworth RF, Zayed J, et al. Manganese depo- sition in basal ganglia structures results from both portal- systemic shunting and liver dysfunction. Gastroenterology 1999;117(3):640-4.
- Krieger D, Krieger S, Jansen O, Gass P, Theilmann L, Lich- tnecker H. Manganese and chronic hepatic encephalopathy. Lancet 1995;346(8970):270-4.
- Fitsanakis VA, Zhang N, Garcia S, Aschner M. Manganese (Mn) and iron (Fe): interdependency of transport and regu- lation. Neurotox Res 2010;18:124-31.
- Weissenborn K, Ehrenheim C, Hori A, Kubicka S, Manns MP. Pallidal lesions in patients with liver cirrhosis: clinical and MRI evaluation. Metab Brain Dis 1995;10(3):219-31.
- Pomier-Layrargues G, Spahr L, Butterworth RF. Increased manganese concentrations in pallidum of cirrhotic patients. Lancet 1995;345(8951):735-7.
- Ikeda S, Yamaguchi Y, Sera Y, et al. Manganese deposition in the globus pallidus in patients with biliary atresia. Trans- plantation 2000; 69(11):2339-43.
- Kashida H, Kondo M, Fukunaga T, et al. Reversal of portal- systemic encephalopathy by shunt-preserving disconnec- tion of portal and systemic circulation. Nihon Shokakibyo Gakkai Zasshi 1996;93(2):96-103.
Öz
Hepatik ensefalopati (HE), kronik karaciğer hastalarınında izlenen nöropsikiyatrik bir sendromdur. Amonyak düzeyle-rine ek olarak beyinde artmış manganez düzeyinin de HE patogenezinde rolü olduğu düşünülmektedir. Karaciğer si-rozlu hastalarda Manyetik Resonans incelemenin (MRI) T1 ağırlıklı kesitlerinde globus palliduslarda simetrik hiperin-tens görünüm, manganez depozisyonuna ilişkin karakteristik bir bulgudur. Biz bu makalede porto-sistemik ensefalo-patili bir vakayı, tipik MR görüntüsü ve artmış kan manganez düzeyi ile sunmaktayız.
Anahtar Kelimeler
Kronik karaciğer hastalığı manganez T1 ağırlıklı hiperintensite
Kaynakça
- Spahr L, Butterworth RF, Fontaine S, et al. Increased blood manganese in cirrhotic patients: relationship to pallidal magnetic resonance signal hyperintensity and neurological symptoms. Hepatology 1996;24(5):1116-20.
- Riordan S.M, Williams R. Treatment of hepatic encephalopa- thy. N Engl J Med 1997;337 (7):473-9.
- Choi Y, Park JK, Park NH, et al. Whole blood and red blood cell manganese reflected signal intensities of T1-weighted magnetic resonance images better than plasma manganese in liver cirrhotics. J Occup Health 2005;47(1):68-73.
- Hauser RA, Zesiewicz TA, Rosemurgy AS, Martinez C, Ola- now CW. Manganese intoxication and chronic liver failure. Ann Neurol 1994;36(6):871-5.
- Krieger D. Manganese may be of importance in the patho- genesis of chronic hepatic encephalopathy. Biomed Phar- macotherapy 1996;50(2):93-6.
- Gospe SM Jr, Caruso RD, Clegg MS, et al. Paraparesis, hy- permanganesaemia, and polycythaemia: a novel presenta- tion of cirrhosis. Arch Dis Child 2000;83(5):439-42.
- Rose C, Butterworth RF, Zayed J, et al. Manganese depo- sition in basal ganglia structures results from both portal- systemic shunting and liver dysfunction. Gastroenterology 1999;117(3):640-4.
- Krieger D, Krieger S, Jansen O, Gass P, Theilmann L, Lich- tnecker H. Manganese and chronic hepatic encephalopathy. Lancet 1995;346(8970):270-4.
- Fitsanakis VA, Zhang N, Garcia S, Aschner M. Manganese (Mn) and iron (Fe): interdependency of transport and regu- lation. Neurotox Res 2010;18:124-31.
- Weissenborn K, Ehrenheim C, Hori A, Kubicka S, Manns MP. Pallidal lesions in patients with liver cirrhosis: clinical and MRI evaluation. Metab Brain Dis 1995;10(3):219-31.
- Pomier-Layrargues G, Spahr L, Butterworth RF. Increased manganese concentrations in pallidum of cirrhotic patients. Lancet 1995;345(8951):735-7.
- Ikeda S, Yamaguchi Y, Sera Y, et al. Manganese deposition in the globus pallidus in patients with biliary atresia. Trans- plantation 2000; 69(11):2339-43.
- Kashida H, Kondo M, Fukunaga T, et al. Reversal of portal- systemic encephalopathy by shunt-preserving disconnec- tion of portal and systemic circulation. Nihon Shokakibyo Gakkai Zasshi 1996;93(2):96-103.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2012 |
| Gönderilme Tarihi | 2 Mart 2015 |
| Yayımlandığı Sayı | Yıl 2012 Cilt: 39 Sayı: 1 |