Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 21, 2017; 23(47): 8432-8436
Published online Dec 21, 2017. doi: 10.3748/wjg.v23.i47.8432
Wernicke encephalopathy in a patient after liver transplantation: A case report
Bin Xie, Zhong-Zhou Si, Wei-Ting Tang, Hai-Zhi Qi, Ting Li
Bin Xie, Zhong-Zhou Si, Hai-Zhi Qi, Ting Li, Organ Transplantation Center, The Second Xiang-ya Hospital, Central South University, Changsha 410011, Hunan Province, China
Wei-Ting Tang, Department of Neurology, Xiang-ya Hospital, Central South University, Changsha 410008, Hunan Province, China
Author contributions: Xie B designed the study and wrote the manuscript; Si ZZ and Li T performed the operation; Xie B and Tang WT collected the clinical data; Qi HZ and Li T were involved in editing of the manuscript and provided financial support.
Supported by National Natural Science Foundation of China, No. 81200326; Natural Science Foundation of Hunan Province, No. 2016JJ3165.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ting Li, MD, PhD, Associate Research Scientist, Surgeon, Organ Transplantation Center, The Second Xiang-ya Hospital, Central South University, No. 139 Middle Renmin Road, Changsha 410011, Hunan Province, China. liting001@csu.edu.cn
Telephone: +86-731-85295808 Fax: +86-731-85295808
Received: October 20, 2017
Peer-review started: October 23, 2017
First decision: November 8, 2017
Revised: November 22, 2017
Accepted: November 27, 2017
Article in press: November 27, 2017
Published online: December 21, 2017
Abstract

Wernicke encephalopathy (WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism and is rare in acute liver failure. So far, there are 2 cases of WE reported after liver transplantation. Here, we report a case of a 45-year-old nonalcoholic male patient who developed psychiatric and neurological disturbance 15 d after receiving orthotopic liver transplantation because of hepatitis B-related cirrhosis and portal hypertension. Brain magnetic resonance imaging (MRI) showed symmetric high-signal intensities in the periaqueductal area. The patient was diagnosed with WE and given intravenous high-dose vitamin B1 immediately. His neurological disturbance resolved in 7 d after receiving the vitamin B1. Brain MRI after 5 mo showed nearly complete recovery. Most WE cases may be misdiagnosed in patients after liver transplantation, and we should pay more attention to its onset.

Keywords: Liver transplantation, Thiamine deficiency, Wernicke encephalopathy, Magnetic resonance imaging, Prevention, Pharmacotherapy

Core tip: Wernicke encephalopathy (WE) is rare in acute liver failure. This is the third case of WE after liver transplantation reported. Most WE may be misdiagnosed in patients after liver transplantation.