Authors :
Ana Francisca Aires; Mariana Lázaro
Volume/Issue :
Volume 11 - 2026, Issue 4 - April
Google Scholar :
https://tinyurl.com/ycy4e3jk
Scribd :
https://tinyurl.com/445xfesa
DOI :
https://doi.org/10.38124/ijisrt/26apr071
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Hepatic encephalopathy is a serious neuropsychiatric complication of acute or chronic liver dysfunction and
represents a major cause of morbidity among patients with chronic liver disease. We report the case of a 51-year-old
female patient from Guinea with a history of chronic hepatitis B since childhood who presented with progressive
neuropsychiatric symptoms, including behavioral disturbances and auditory hallucinations, necessitating hospitalization
in the psychiatric ward. Laboratory investigations revealed markedly elevated liver enzymes, including aspartate
aminotransferase (AST) 250 U/L, alanine aminotransferase (ALT) 450 U/L, and gamma-glutamyl transferase (GGT) 2000
U/L, accompanied by hyperammonemia of 170 µmol/L. The patient was managed with lactulose and antipsychotic therapy
(paliperidone), resulting in gradual improvement of mental status and behavioral symptoms. This case emphasizes the
importance of early recognition and appropriate management of neuropsychiatric manifestations in hepatic
encephalopathy.
Keywords :
Hepatic Encephalopathy, Hepatitis B, Neuropsychiatric Symptoms, Hyperammonemia.
References :
- A. Schiff, Diseases of the Liver, 11th ed., Philadelphia: Lippincott, 2018, pp. 245-260.
- J. Ferenci, “Hepatic encephalopathy,” Gastroenterology, vol. 123, pp. 726-742, 2002.
- M. Amodio, F. Montagnese, and R. Gatta, “Neuropsychiatric manifestations of hepatic encephalopathy,” Metab Brain Dis, vol. 20, pp. 141–150, 2005.
- K. Bustamante, P. Rimola, and J. Ventura, “Clinical features and prognosis of hepatic encephalopathy in patients with cirrhosis,” J Hepatol, vol. 20, pp. 565–572, 1994.
- R. Blei and M. Cordoba, “Current concepts in the management of hepatic encephalopathy,” N Engl J Med, in press.
- L. Shawcross, and P. Jalan, “The pathophysiology of hepatic encephalopathy: recent advances,” Clin Liver Dis, vol. 10, pp. 669–684, 2006.
Hepatic encephalopathy is a serious neuropsychiatric complication of acute or chronic liver dysfunction and
represents a major cause of morbidity among patients with chronic liver disease. We report the case of a 51-year-old
female patient from Guinea with a history of chronic hepatitis B since childhood who presented with progressive
neuropsychiatric symptoms, including behavioral disturbances and auditory hallucinations, necessitating hospitalization
in the psychiatric ward. Laboratory investigations revealed markedly elevated liver enzymes, including aspartate
aminotransferase (AST) 250 U/L, alanine aminotransferase (ALT) 450 U/L, and gamma-glutamyl transferase (GGT) 2000
U/L, accompanied by hyperammonemia of 170 µmol/L. The patient was managed with lactulose and antipsychotic therapy
(paliperidone), resulting in gradual improvement of mental status and behavioral symptoms. This case emphasizes the
importance of early recognition and appropriate management of neuropsychiatric manifestations in hepatic
encephalopathy.
Keywords :
Hepatic Encephalopathy, Hepatitis B, Neuropsychiatric Symptoms, Hyperammonemia.
