Meeting Banner
Abstract #3213

Study of Serial DTT, Brain Morphometry, Clinical, Serum Cytokines, Cognition Changes in Children with Acute Liver Failure

Abhishek Yadav1, Anshu Srivastava2, Santosh Kumar Yadav1, Vibhore V. Borkar, Surendra Kumar Yachha, Rakesh Kumar Gupta1

1Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, Lucknow, Uttar Pradesh, India; 2Paediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, Lucknow, Uttar Pradesh, India

This prospective serial study was done to look for reversibility of changes in MRI, MRS, proinflammatory cytokines, thiamine, and neurocognitive functions in these children over time. 11 ALF patients and 8 healthy controls were evaluated. TNF-α, IL-6 and Glx were significantly higher while thiamine, MD and MB volume were significantly lower than the controls. ALF subjects performed poorly in 8 of the 9 and improved in all the administered tests as compared to that in first follow up. In conclusion, the recovery in ALF is prolonged and goes well beyond the apparent recovery in HE. CE and brain glutamine recover first, followed by normalization of neuropsychological tests and liver functions. The brain choline and MBs take a longer time to normalize than the glutamine and CE.

Keywords

abnormalities abnormality absence achieved acute administered admission adult adults afferents almost ammonia apparent batteries behavior blood boys brain cell cells cerebral children choline clinical cognitive coil complete completely consequent continued controls correlation days decreased deranged designed despite detect diagnosis difficult diffusion done edema elevated evaluated explain explained failure field fisher flow former functions global glutamate grade graduate grossly healthy illness impairment important improvement incomplete individual infect inflammatory institute jaundice kits lead limbic liver loss major markedly mass materials medical morbidity mortality much normalization normalize occipital overt package patient patients performance period persistence poor poorly positive post posterior presence previous produce quantification quantified raised recovered recovers recovery reduced reduction regeneration reported resolve resolved response revised role sciences scores secondary serial serum shimming significantly sirs slice software source spectroscopy spectrum square stage still student studies subsequent supplementation supplied supports suppression syndrome take thiamine transplantation underwent uniformly unpaired variables volume weeks white width year