Browse > Article

Case Report of Liver Cirrhosis with Diabetes Mellitus and Hepatic Encephalopathy  

Na, Ran-Hee (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University)
Lee, Jung-Wook (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University)
Han, Deok-Jin (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University)
Bang, Chang-Ho (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University)
Jang, Seok-Oh (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University)
Choi, Ji-Hye (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University)
Kim, Kang-San (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University)
Publication Information
Journal of Physiology & Pathology in Korean Medicine / v.23, no.4, 2009 , pp. 919-924 More about this Journal
Abstract
The liver is one of the principal organs involved in glucose metabolism. Diabetes mellitus(DM) commonly develops in patients with liver cirrhosis as a result of hepatocyte dysfunction. Hepatic encephalopathy(HE) is a major neuropsychiatric complication of liver cirrhosis. HE develops frequently in advanced stage of liver cirrhosis due to portal hypertension. We experienced a case of liver cirrhosis with DM and HE in 67 years old male patient. The patient's symptoms were lethargy, general malaise, asterixis, dizziness, and heavy headedness. Hwangryunjihwang-tang, Saengkankunbi-tang, Injinchija-tang and Injinho-tang were prescribed to the patient. Finally, the symptoms had been improved, however significant change was not observed from serum ammonia, fasting blood sugar and postparandial blood sugar. So we hope that this case report will be helpful in treating patient of liver cirrhosis.
Keywords
liver cirrhosis; diabetes mellitus; hepatic encephalopathy;
Citations & Related Records
Times Cited By KSCI : 4  (Citation Analysis)
연도 인용수 순위
1 Riordan, S.M., Williams, R. Treatment of hepaticencephalopathy. N Eng J Med. 337: 473-479, 1997   DOI   PUBMED   ScienceOn
2 Merli, M., Riggio, O. Dietary and nutritional indications in hepatic encephalopathy. Metab Brain Dis. 24(1):211-221, 2009   DOI   ScienceOn
3 김정룡. 소화기계 질환 제2판. 서울, 일조각, pp 662-671, 708-718, 2005
4 Megyesi, C., Samols, E., Marks, V. Glucose tolerance and diabetes in chronic liver disease. Lancet. 2: 1051-1055, 1967   PUBMED
5 Creutzefeld, W., Frerichs, H., Sicklinger, K. Liver diseases and diabetes mellitus. In: Poppper, H., Schaffner, F., eds. Progress in Liver Diseases, 3rd ed. New York, Grune & Stratton Publishers. pp 371-407, 1970
6 Selberg, O., Burchert, W., vd Hoff, J., Meyer, G.J., Hundeshagen, H., Radoch, E., Balks, H.J., Müller, M.J. Insulin resistance in liver cirrhosis. Positron-emission tomography scan analysis of skeletal muscle glucose metabolism. J Clin Invest. 91(5):1897-1902, 1993   DOI   ScienceOn
7 Nolte, W., Hartmann, H., Ramadori, G. Glucose metabolism and liver cirrhosis. Exp Clin Endocrinol Diabetes. 103(2):63-74, 1995   DOI   ScienceOn
8 손호영. 간경변증의 당뇨조절. 대한간학회 추계학술대회 초록집, 4(3s):1-7, 1998
9 Atterbury, C.E., Maddrey, W.C., Conn, H.O. Neomycin- sorbitol and lactulose in the treatment of acute portal-systemic encephalopathy. A controlled, double-blind clinical trial. Am J Dig Dis, 23: 398-406, 1978   DOI   ScienceOn
10 Butterworth, R.F. Hepatic encephalopathy:disorder of multiple neurotransmitter systems. In:Curr Opin Neurol. 13(6):721-727, 2000   DOI   PUBMED   ScienceOn
11 Lockwood, A.H., Yap, E.W., Wong, W.H. Cerebral ammonia metabolism in patients with severe liver disease and minimal hepatic encephalopathy. J Cereb Blood Flow Metab. 11(2):337-341, 1991   DOI
12 Plauth, M., Merli, M., Kondrup, J., Weimann, A., Ferenci, P., Müller, M.J. ESPEN guidelines for nutrition in liver disease and transplantation. Clin Nutr. 16: 43-55, 1997
13 허준. 동의보감. 서울, 법인문화사, 2007
14 Holstein, A., Hinze, S., Thiessen, E., Plaschke, A., Egberts, E.H. Clinical implications of hepatogenous diabetes in liver disease. J Gastroenterol Hepatol. 17: 677-681, 2002   DOI   ScienceOn
15 윤현정, 김병완, 이창현, 정재하, 허숙경, 박원환, 박선동. 사람 간암 세포주인 HepG2에 대한 인진호탕의 항암 효과. 대한본초학회지 22(3):27-37, 2007   과학기술학회마을
16 김민근, 최원충. 간경변증 환자에서 유발된 당뇨병과 다른 제2형 당뇨병 환자의 감별진단. 대한간학회지 12(4):524-529, 2006
17 Hawkins, R.A., Jessy, J., Mans, A.M., Chedid, A., DeJoseph, M.R. Neomycin reduces the intestinal production of ammonia from glutamine. Adv Exp Med Biol. 368: 125-134, 1994   PUBMED
18 김병운. 만성간염 3,136예에 대한 임상분석과 생간건비탕의 치료효과. 대한한의학회지 14(1):216-223, 1997
19 김유창, 김승모, 박지하, 서부일, 최홍식. 인진호탕과 한인진호탕이 알코올 투여로 유발된 흰쥐의 고지혈증과 간 손상의 예방에 미치는 영향. 대한본초학회지 21(3):47-54, 2006   과학기술학회마을
20 McDermott, W.V.Jr., Adams, R.D. Episodic stupor associated with an Eck fistula in the human with particular reference to the metabolism of ammonia. J Clin Invest. 33(1):1-9, 1954   DOI   PUBMED   ScienceOn
21 Ferenci, P., Lockwood, A., Mullen, K., Tarter, R., Weissenborn, K., Blei, A.T. Hepatic encephalopathy- definition, nomenclature, diagnosis, and quantification, final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology. 35(3):716-721, 2002   DOI   ScienceOn
22 Abou-Assi, S., Vlahcevic, Z.R. Hepatic encephalopathy : metabolic consequence of cirrhosis often is reversible. Postgrad Med. 109: 52-70, 2001   DOI   PUBMED
23 Shawcross, D., Jalan, R. Dispelling myths in the treatment of hepatic encephalopathy. Lancet. 365: 431-433, 2005   DOI   PUBMED
24 Shmueli, E., Record, C.O., Alberti, K.G.M.M. Liver disease, carbohydrate metabolism and diabetes. In: Burger, H.G., ed. Bailliere's Clinical Endocrinology and Metabolism. 6th ed. London:WB Saunders. pp 719-743, 1992
25 차종태. 치자대황탕과 인진치자탕 extract가 백서의 간손상에 미치는 영향. 대한한의학방제학회지 1(1):126-138, 1990   과학기술학회마을
26 Naunyn, B. Der diabetes mellitus. Holder W, editor. pp 6-7, 1898
27 Clausen, M.R., Mortensen, P.B. Lactulose, disaccharides and colonic flora. Clinical consequences. Drugs. 53: 930-942, 1997   DOI   ScienceOn
28 Harrison, S.A. Liver disease in patient with diabetes mellitus. J Clin Gastroenterol. 40: 68-76, 2006   DOI   PUBMED   ScienceOn
29 김재용, 김영철, 이장훈, 우홍정. 생간건비탕이 HepG2 cell의 증식, 세포사멸 및 활성조절 신호전달계에 미치는 영향. 대한한방내과학회지 27(1):149-165, 2006   과학기술학회마을
30 전국한의과대학 간계내과학교수. 간계내과학. 제4판. 서울, 동양의학연구원, pp 48, 323-350, 2001
31 Cordoba, J., Lopez-Hellin, J., Planas, M., et al. Normal protein diet for episodic hepatic encephalopathy:results of a randomized study. J Hepatol. 41: 38-43, 2004   DOI   ScienceOn
32 Petrides, A.S., Vogt, C., Schulze-Berge, D., Matthews, D., Strohmeyer, G. Pathogenesis of glucose intolerance and diabetes mellitus in cirrhosis. Hepatology. 19: 616-627, 1994   DOI   ScienceOn
33 강신익, 박민호, 안세영, 두호경. 동의보감 소갈문에 수록된 처방들의 혈당강하효과에 대한 초보적 검색. 대한한의학회지 19(1):27-37, 1998   과학기술학회마을
34 Conn, H.O., Leevy, C.M., Vlahcevic, Z.R., et al. Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. A Double blind controlled trial. Gastroenterology. 72: 573-583, 1997
35 정승식, 최승훈, 안규석. 인진호탕 및 인진호탕가미방이 생쥐의 담석증모형에 미치는 영향. 대한동의생리학회지 6(1):159- 170, 1991