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


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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Article Type: Case Report

Eur J Gen Med, 2012 - Volume 9 Issue 4, pp. 277-279

Publication date: 10 Oct 2012

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Article Downloads: 189

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