Two Cases of Hemodialysis-associated Chronic Portal-systemic Shunt Encephalopathy (CPSE) with Opposite Changes in the Blood Ammonia Concentrations during Hemodialysis: A Case Report and Literature Review.

@article{Oi2015TwoCO,
  title={Two Cases of Hemodialysis-associated Chronic Portal-systemic Shunt Encephalopathy (CPSE) with Opposite Changes in the Blood Ammonia Concentrations during Hemodialysis: A Case Report and Literature Review.},
  author={Katsuyuki Oi and Tomokazu Okado and Hisako Togo and Soichiro Iimori and Naofumi Yui and E Sohara and Eiichiro Kanda and Tatemitsu Rai and Sei Sasaki and Shinichi Uchida},
  journal={Internal medicine},
  year={2015},
  volume={54 11},
  pages={1375-80}
}
The onset of hyperammonemia due to the flow of ammonia-rich portal vein blood through a portal-systemic shunt causes a type of encephalopathy known as chronic portal-systemic shunt encephalopathy (CPSE). We herein report two cases of CPSE that presented with opposite changes in the blood ammonia concentrations during hemodialysis. It is curious that the encephalopathy was ameliorated by hemodialysis in case 1, but not case 2. Therefore, it is necessary to recognize CPSE and assess the blood… CONTINUE READING
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