Oral glutamine challenge and magnetic resonance spectroscopy in three patients with congenital portosystemic shunts.
J Hepatol
; 40(3): 552-7, 2004 Mar.
Article
en En
| MEDLINE
| ID: mdl-15123374
ABSTRACT
BACKGROUND/AIMS:
Congenital portosystemic shunts are rare abnormalities of liver vasculature that can cause neurological symptoms, probably secondarily to the effects of the metabolism of ammonia in the brain. Our aim was to investigate the relationship between capillary blood ammonia after oral glutamine challenge and magnetic resonance spectroscopy in three patients with congenital portosystemic shunts.METHODS:
Neuropsychological tests, oral glutamine challenge and magnetic resonance spectroscopy were performed at baseline and after 6 months of follow-up in three patients with congenital portosystemic shunts. The results were compared to those obtained in a group of six cirrhotic patients with prior episodes of hepatic encephalopathy and healthy controls.RESULTS:
Patients with congenital portosystemic shunts exhibited abnormalities of neuropsychological tests, magnetic resonance spectroscopy and a response to the oral glutamine challenge similar to those observed in patients with cirrhosis. The intensity of the rise of brain glutamine was correlated to the area under the curve of ammonia after the oral glutamine challenge (R=0.72).CONCLUSIONS:
Neurological manifestations of patients with congenital portosystemic shunts are mediated through similar mechanisms that are involved in the pathogenesis of hepatic encephalopathy. The area under the curve appears to be the better parameter that defines the response to the oral glutamine challenge.
Buscar en Google
Bases de datos:
MEDLINE
Asunto principal:
Sistema Porta
/
Espectroscopía de Resonancia Magnética
/
Anomalías Cardiovasculares
/
Glutamina
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Hepatol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2004
Tipo del documento:
Article
País de afiliación:
España