Liver transplantion in a patient with rapid onset parkinsonism-dementia complex induced by manganism secondary to liver failure

被引:18
作者
Fabiani, Giorgio [1 ]
Rogacheski, Enio
Wiederkehr, Julio Cesar
Khouri, Jussara
Cianfarano, Andrea
机构
[1] Pontificia Univ Catolica Parana, Hosp Caridade Irmandade Santa Casa Nisericordia C, Curitiba, Parana, Brazil
[2] Univ Fed Parana, Dept Radiol, BR-80060000 Curitiba, Parana, Brazil
[3] DAPI, Curitiba, Parana, Brazil
[4] UFPR, Hosp Caridade Irmandade Santa Casa Nisericordia C, Dept Surg & Hepat Transplantat, Curitiba, Parana, Brazil
关键词
manganese; liver transplantation; parkinsonism-dementia; globus pallidus; high-signal; HEPATIC-ENCEPHALOPATHY;
D O I
10.1590/S0004-282X2007000400027
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Bilateral and symmetric globus-pallidus hyperintensities are observed on T1-weighted MRI in most of the patients with chronic liver failure, due to manganese accumulation. We report a 53-year-old man, with rapid onset parkinsonism-dementia complex associated with accumulation of manganese in the brain, secondary to liver failure. A brain MRI was performed and a high signal on T1-weighted images was seen on globus-pallidus, as well as on T2-weighted images on the hemispheric white-matter. He was referred to a liver-transplantation. The patient passed away on the seventh postoperative day. Our findings support the concept of the toxic effects of manganese on the globus-pallidus. The treatment of this form of parkinsonism is controversial and liver-transplantation should not be considered as first line treatment but as an alternative one.
引用
收藏
页码:685 / 688
页数:4
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