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Profile of hepatic encephalopathy in children with cirrhosis and response to lactulose.
Saudi J Gastroenterol. 2011 Mar-Apr; 17(2):138-41.SJ

Abstract

BACKGROUND/AIM

Hepatic encephalopathy (HE) is associated with a poor prognosis. There is paucity of data on the treatment of HE with lactulose in children with cirrhosis.

PATIENTS AND METHODS

Retrospective analysis of consecutive cirrhotic patients (<18 years) with HE was done. HE was defined according to West-Haven criteria. Response was defined as complete if patients recovered completely from HE, partial response was defined as improvement of encephalopathy by one or more grades from admission but not complete recovery, and defined as non response if patient did not show any improvement or deteriorated further even after 10 days of lactulose therapy.

RESULTS

A total of 300 patients were admitted with cirrhosis and HE (278 adults and 22 children). Of 22 patients, 16 (73%) patients had complete response to lactulose and six (27%) patients did not [three (13.5%) patients worsened (non response) and three (13.5%) did not recover fully even after 10 days of treatment (partial response)]. Comparing baseline characteristics of patients who had complete response (n=16) versus partial (n=3) and non response (n=3), there was significant difference in mean arterial pressure (78.1±10.7 vs 62.6±5.0 mmHg, P=0.003), serum sodium (131.3±3.2 vs 126.5±5.2, P=0.01) and serum creatinine (0.78±0.3 vs 1.1±0.3 mg/dl, P=0.02). We did not find any difference in baseline characteristics of these patients regarding CTP score (9.6±1.2 vs 10.6±1.2), MELD score (17.6±2.9 vs 17.1±3.4), severity of HE (2.5±0.6 vs 2.6±0.5) and etiology of precipitating factors (P=0.78).

CONCLUSIONS

Lactulose therapy causes complete recovery from hepatic encephalopathy in 73% of pediatrics patients with cirrhosis.

Authors+Show Affiliations

Department of Gastroenterology, G. B. Pant Hospital, New Delhi, India. drbcsharma@hotmail.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21372353

Citation

Sharma, Praveen, and Barjesh C. Sharma. "Profile of Hepatic Encephalopathy in Children With Cirrhosis and Response to Lactulose." Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association, vol. 17, no. 2, 2011, pp. 138-41.
Sharma P, Sharma BC. Profile of hepatic encephalopathy in children with cirrhosis and response to lactulose. Saudi J Gastroenterol. 2011;17(2):138-41.
Sharma, P., & Sharma, B. C. (2011). Profile of hepatic encephalopathy in children with cirrhosis and response to lactulose. Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association, 17(2), 138-41. https://doi.org/10.4103/1319-3767.77246
Sharma P, Sharma BC. Profile of Hepatic Encephalopathy in Children With Cirrhosis and Response to Lactulose. Saudi J Gastroenterol. 2011 Mar-Apr;17(2):138-41. PubMed PMID: 21372353.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Profile of hepatic encephalopathy in children with cirrhosis and response to lactulose. AU - Sharma,Praveen, AU - Sharma,Barjesh C, PY - 2011/3/5/entrez PY - 2011/3/5/pubmed PY - 2011/7/27/medline SP - 138 EP - 41 JF - Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association JO - Saudi J Gastroenterol VL - 17 IS - 2 N2 - BACKGROUND/AIM: Hepatic encephalopathy (HE) is associated with a poor prognosis. There is paucity of data on the treatment of HE with lactulose in children with cirrhosis. PATIENTS AND METHODS: Retrospective analysis of consecutive cirrhotic patients (<18 years) with HE was done. HE was defined according to West-Haven criteria. Response was defined as complete if patients recovered completely from HE, partial response was defined as improvement of encephalopathy by one or more grades from admission but not complete recovery, and defined as non response if patient did not show any improvement or deteriorated further even after 10 days of lactulose therapy. RESULTS: A total of 300 patients were admitted with cirrhosis and HE (278 adults and 22 children). Of 22 patients, 16 (73%) patients had complete response to lactulose and six (27%) patients did not [three (13.5%) patients worsened (non response) and three (13.5%) did not recover fully even after 10 days of treatment (partial response)]. Comparing baseline characteristics of patients who had complete response (n=16) versus partial (n=3) and non response (n=3), there was significant difference in mean arterial pressure (78.1±10.7 vs 62.6±5.0 mmHg, P=0.003), serum sodium (131.3±3.2 vs 126.5±5.2, P=0.01) and serum creatinine (0.78±0.3 vs 1.1±0.3 mg/dl, P=0.02). We did not find any difference in baseline characteristics of these patients regarding CTP score (9.6±1.2 vs 10.6±1.2), MELD score (17.6±2.9 vs 17.1±3.4), severity of HE (2.5±0.6 vs 2.6±0.5) and etiology of precipitating factors (P=0.78). CONCLUSIONS: Lactulose therapy causes complete recovery from hepatic encephalopathy in 73% of pediatrics patients with cirrhosis. SN - 1998-4049 UR - https://www.unboundmedicine.com/medline/citation/21372353/Profile_of_hepatic_encephalopathy_in_children_with_cirrhosis_and_response_to_lactulose_ L2 - http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2011;volume=17;issue=2;spage=138;epage=141;aulast=Sharma DB - PRIME DP - Unbound Medicine ER -