vitamin-b-12 and Hepatic-Encephalopathy

Forty-six male alcoholics hospitalized with polyneuropathy or intellectual impairment were studied after at least 2 wk of alcohol abstention. Neurological evaluation included neurophysiological examination of the sural nerve and tibial nerve, neurophysiological examinations, and CT-scanning of the brain. Alcohol and vitamin intakes were quantified by the interview method. Vitamin B-12 and folate status included examinations of peripheral blood and bone marrow aspirate, plasma vitamin B-12, plasma and erythrocyte folate, formiminoglutamic acid excretion test (FiGlu), methylmalonic acid excretion, and deoxyuridine suppression test (dU) on phytohemagglutinin-stimulated peripheral lymphocytes. The liver function was assessed by galactose elimination capacity and plasma clearance of antipyrine. There was no hematological sign of folate or vitamin B-12 deficiency. About 8% had low plasma folate, while neither erythrocyte folate nor plasma vitamin B-12 were decreased. However, half of the patients had functional folate deficiency as determined by abnormal FiGlu or dU. Compared to the remaining patients, those with abnormal FiGlu or dU had significantly more abnormal neurophysiological tests, and lower folate intake. There was no correlation between FiGlu or dU and the quantitative liver function tests. It is concluded that 1) folate deficiency may contribute to the development of alcoholic polyneuropathy, 2) the classical parameters for folate deficiency (blood concentrations, peripheral blood, and bone marrow examinations) are not reliable in diagnosing folate deficiency and 3) functional tests like FiGlu and dU are necessary to diagnose folate deficiency in alcoholics.

Topics: Adult; Alcoholism; Deoxyuridine; Folic Acid; Folic Acid Deficiency; Formiminoglutamic Acid; Hematologic Tests; Hepatic Encephalopathy; Humans; Liver Function Tests; Male; Middle Aged; Neurologic Examination; Peripheral Nervous System Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged; Agranulocytosis; Anemia, Pernicious; Hepatic Encephalopathy; Humans; Injections, Intramuscular; Male; Vitamin B 12

Topics: Adolescent; Adult; Ascites; Bed Rest; Bloodletting; Child; Child, Preschool; Cholestyramine Resin; Dietary Fats; Dietary Proteins; Diuretics; Energy Intake; Female; Hemochromatosis; Hepatic Encephalopathy; Hepatolenticular Degeneration; Humans; Lactulose; Liver Cirrhosis; Liver Cirrhosis, Biliary; Male; Middle Aged; Mineralocorticoid Receptor Antagonists; Penicillamine; Potassium; Vitamin B 12

An outbreak of white liver disease in lambs in Western Australia is described. The disease affected 2- to 3-month-old lambs and was characterised by liver damage, severe ill-thrift, depression, serous ocular discharge, photosensitization, and a high mortality rate. Transient central nervous system signs occurred. A positive response to vitamin B12 therapy was demonstrated.

Topics: Animals; Animals, Newborn; Cobalt; Hepatic Encephalopathy; Liver Diseases; Seasons; Sheep; Sheep Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged; Brain Diseases; Electroencephalography; Hepatic Encephalopathy; Humans; Infusions, Parenteral; Liver Diseases; Methods; Middle Aged; Rutin; Vitamin A; Vitamin B 12; Vitamin B Complex

Topics: Adolescent; Ascorbic Acid; Cortisone; gamma-Globulins; Hepatic Encephalopathy; Hepatitis; Hepatitis A; Humans; Infusions, Parenteral; Niacin; Niacinamide; Pyridoxine; Riboflavin; Vitamin B 12; Vitamin E