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2014, Number 3

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Ann Hepatol 2014; 13 (3)

Patients with hyponatremic cirrhosis have low-grade cerebral edema and poor quality-of-life

Iwasa M, Sugimoto R, Takei Y

Language: English
References: 7
Page: 407-408
PDF size: 57.16 Kb.


Text Extraction

Recently, Wunsch, et al. reported that hyponatremia, psychometric hepatic encephalopathy (HE) score, critical flicker frequency and severity of liver disease affect health-related quality-of-life (HRQOL) in patients with cirrhosis.1 In addition, Ahluwalia, et al. evaluated the contribution of hyponatremia to impairment HRQOL, cognitive dysfunction and brain magnetic resonance (MR) spectroscopy parameters in cirrhotic patients independently of HE.2 They showed that cirrhotic patients with hyponatremia had worse HRQOL despite better cognition and the poor HRQOL was associated with decreased myoinositol. Based on these observations, they concluded that hyponatremia worsens HRQOL due to changes in brain osmolarity in subjects with hyponatremia compared to those without it.


REFERENCES

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  2. Ahluwalia V, Wade JB, Thacker L, Kraft KA, Sterling RK, Stravitz RT, Fuchs M, et al. Differential Impact of Hyponatremia and Hepatic Encephalopathy on Health- Related Quality of Life and Brain Metabolite Abnormalities in Cirrhosis. J Hepatol 2013; 59: 467-73.

  3. Lemberg A, Fernández MA. Hepatic encephalopathy, ammonia, glutamate, glutamine and oxidative stress. Ann Hepatol 2009; 8: 95-102.

  4. Sawara K, Kato A, Yoshioka Y, Suzuki K. Brain glutamine and glutamate levels in patients with liver cirrhosis: assessed by 3.0-T MRS. Hepatol Res 2004; 30: 18-23.

  5. Sugimoto R, Iwasa M, Maeda M, Urawa N, Tanaka H, Fujita N, Kobayashi Y, et al. Value of the apparent diffusion coefficient for quantification of low-grade hepatic encephalopathy. Am J Gastroenterol 2008; 103: 1413-20.

  6. Ginčs P, Guevara M. Hyponatremia in cirrhosis: pathogenesis, clinical significance, and management. Hepatology 2008; 48: 1002-10.

  7. Förster A, Nölte I, Wenz H, Al-Zghloul M, Kerl HU, Brockmann C, Brockmann MA, et al. Value of diffusion-weighted imaging in central pontine and extrapontine myelinolysis. Neuroradiology 2013; 55: 49-56




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