A rare case of hemodialysis-related portosystemic encephalopathy and review of the literature

Hemodialysis-related portosystemic encephalopathy (HRPSE) is a clinical phenomenon where portosystemic encephalopathy (PSE) develops without liver dysfunction, usually caused by changes in the portosystemic blood flow related to hemodialysis. We describe the case of a 22-year old patient with a tran...

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Bibliographic Details
Published in:Acta clinica belgica (English ed. Online) 2020-08, Vol.75 (4), p.296-300
Main Authors: Geerinckx, Barbara, Hellemans, Rachel, Van Craenenbroeck, Amaryllis H, Francque, Sven, De Waele, Liesbeth, Kerstens, Jeroen, Van Gaal, Pieter-Jan, Bracke, Bart, Michielsen, Peter, Vanwolleghem, Thomas
Format: Article
Language:English
Subjects:
Brain - diagnostic imaging
Femoral Vein
Gastrointestinal Agents - therapeutic use
Glucocorticoids - administration & dosage
Hemodialysis
Hepatic Encephalopathy - diagnosis
Hepatic Encephalopathy - etiology
Hepatic Encephalopathy - physiopathology
Hepatic Encephalopathy - therapy
Humans
Kidney Failure, Chronic - etiology
Kidney Failure, Chronic - therapy
Lactulose - therapeutic use
Liver Cirrhosis - complications
Liver Cirrhosis - congenital
Magnetic Resonance Imaging
Male
Polycystic Kidney, Autosomal Recessive - complications
Portasystemic Shunt, Transjugular Intrahepatic
Renal Dialysis - adverse effects
Vena Cava, Superior
White Dot Syndromes - complications
White Dot Syndromes - drug therapy
Young Adult
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Summary:Hemodialysis-related portosystemic encephalopathy (HRPSE) is a clinical phenomenon where portosystemic encephalopathy (PSE) develops without liver dysfunction, usually caused by changes in the portosystemic blood flow related to hemodialysis. We describe the case of a 22-year old patient with a transjugular intrahepatic portosystemic shunt (TIPS) who developed HRPSE several months after initiation of hemodialysis. Despite initial therapy with laxatives and neomycin symptoms recurred. It was only after relocation of the hemodialysis catheter from the superior caval vein to the femoral vein that symptoms completely resolved.
ISSN:1784-3286
2295-3337
DOI:10.1080/17843286.2019.1595836