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Hyponatremic and hepatic encephalopathies: similarities, differences and coexistence

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Abstract

Hyponatremic and hepatic encephalopathy are common causes of metabolic encephalopathy that may coexist in patients with cirrhosis. The clinical picture is common to any metabolic encephalopathy and is characterized by a confusional syndrome that may evolve into coma. Chronic mild or minimal manifestations can be seen in both, but motor symptoms are more common in hepatic encephalopathy. Recent advances show that in addition to clinical manifestations both encephalopathies share some pathogenetic mechanisms. Dysfunction of astrocytes, osmotic changes in the brain and brain edema are present in both situations. Recognition of these abnormalities is important to plan therapy. New drugs that affect brain hydration may be useful for both encephalopathies.

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Acknowledgement

CIBERehd is supported by Instituto de Salud Carlos III.

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Authors and Affiliations

  1. Servei de Medicina Interna-Hepatologia, Hospital Universitari Vall d’Hebron, Pg. Vall d’Hebron 119, Barcelona, 08035, Spain

    Juan Córdoba, Rita García-Martinez & Macarena Simón-Talero

  2. Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain

    Juan Córdoba, Rita García-Martinez & Macarena Simón-Talero

  3. CIBERehd, Instituto de Salud Carlos III, Madrid, Spain

    Juan Córdoba

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  1. Juan Córdoba
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Correspondence to Juan Córdoba.

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Córdoba, J., García-Martinez, R. & Simón-Talero, M. Hyponatremic and hepatic encephalopathies: similarities, differences and coexistence. Metab Brain Dis 25, 73–80 (2010). https://doi.org/10.1007/s11011-010-9172-3

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  • DOI: https://doi.org/10.1007/s11011-010-9172-3

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