Minimal encephalopathy in hereditary hemorrhagic telangiectasia patients with portosystemic vascular malformations
Hereditary hemorrhagic telangiectasia (HHT) is characterized by telangiectasia and larger vascular malformations. Liver malformations are the most frequent visceral involvement including the presence of portosystemic malformations (PSM) that can cause hepatic encephalopathy. Minimal hepatic encephal...
| Authors: | , , , , , , , , , , , , |
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| Format: | article |
| Publication Date: | 2024 |
| Country: | España |
| Institution: | Conselleria de Salut i Consum del Govern de les Illes Balears |
| Repository: | Docusalut |
| Language: | English |
| OAI Identifier: | oai:docusalut.com:20.500.13003/21618 |
| Online Access: | https://hdl.handle.net/20.500.13003/21618 |
| Access Level: | Open access |
| Keyword: | Male Aged Quality of Life Vascular Malformations Neuropsychological Tests Female Adult Telangiectasia, Hereditary Hemorrhagic Humans Hepatic Encephalopathy Middle Aged Cross-Sectional Studies Encefalopatía Hepática Telangiectasia Hemorrágica Hereditaria Estudios Transversales Humanos Persona de Mediana Edad Calidad de Vida Anciano Femenino Adulto Pruebas Neuropsicológicas Masculino Malformaciones Vasculares |
| Summary: | Hereditary hemorrhagic telangiectasia (HHT) is characterized by telangiectasia and larger vascular malformations. Liver malformations are the most frequent visceral involvement including the presence of portosystemic malformations (PSM) that can cause hepatic encephalopathy. Minimal hepatic encephalopathy (mHE) is characterized by alterations of brain function in neuropsychological or neurophysiological tests and decreases quality of life. The evidence of mHE in HHT patients is scarce. The aim of this study is to assess the prevalence and health impact of mHE in patients with and without PSM. We performed a cross-sectional observational study in a cohort of patients from an HHT referral unit. Adult patients with definite HHT and PSM and age and sex matched HHT controls without PSM (1:1) were included. Baseline clinical, imaging and laboratory tests and different neuropsychological tests for the screening of mHE were compared between both groups. Eighteen patients with PSM and 18 controls out of 430 HHT patients were included. Patients with PSM showed higher prevalence of attention disturbances (50% vs. 11.1%, p = 0.027), falls during last 12 months (22.2% vs. 5.6%, p = 0.338), sleep disorders (50% vs. 16.7%, p = 0.075) and a worst performance in s-ANT1 test (14 vs. 19.5 points score, p = 0.739) than HHT controls. HHT patients with PSM showed higher attention difficulties than HHT controls, though both PSM and HHT controls showed findings of mHE. Specific neuropsychological tests for early detection of mHE should be considered in HHT patients. |
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