An Unusual Cause of Confusion: Hepatic Encephalopathy in Hereditary Haemorrhagic Telangectasia
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Marianne Tinkler 1 * , Eleanore Lyons 1, Emily Henderson 1
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1 North Bristol NHS Trust, Bristol, UK* Corresponding Author

Abstract

This case report describes a 73 year old lady with a known Hereditary Haemorrhagic Encephalopathy (HHT) who presented with confusion. She had several previous self-limiting episodes over 3 months. She had known hepatic arterio-venous (AV) malformations. A urinary tract infection was detected and thought to be the cause of her confusion. However despite targeted antibiotic treatment her neurological state worsened (GCS 10/15) and she developed hepatic asterixis. Hepatic encephalopathy was confirmed with diagnostic EEG and elevated ammonia 211umol/l (<40). Laxative treatment had transient improvement but she was unsuitable for hepatic AV embolisation or liver transplantation. Hepatic encephalopathy is a rare complication of HHT with less than 10 previous documented cases.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Case Report

EUR J GEN MED, 2012, Volume 9, Issue 4, 277-279

https://doi.org/10.29333/ejgm/82446

Publication date: 10 Oct 2012

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