Chang CY, Liu C, Duan FF, Zhai H, Song SS, Yang S. Spontaneous remission of hepatic myelopathy in a patient with alcoholic cirrhosis: A case report. World J Clin Cases 2022; 10(30): 11172-11177 [PMID: 36338225 DOI: 10.12998/wjcc.v10.i30.11172]
Corresponding Author of This Article
Song Yang, Doctor, PhD, Director, Doctor, Professor, Teacher, Division Third Center of Hepatology, Beijing Ditan Hospital, Capital Medical University, No.8 Jingshun East Street, Chaoyang District, Beijing 100015, China. sduyangsong@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2022; 10(30): 11172-11177 Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.11172
Spontaneous remission of hepatic myelopathy in a patient with alcoholic cirrhosis: A case report
Chun-Yan Chang, Chen Liu, Fang-Fang Duan, Hang Zhai, Shan-Shan Song, Song Yang
Chun-Yan Chang, Chen Liu, Fang-Fang Duan, Hang Zhai, Shan-Shan Song, Song Yang, Division Third Center of Hepatology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Author contributions: Chang CY designed and contributed to the manuscript draft; Liu C and Duan FF analyzed and interpreted the imaging data; Zhai H and Song SS collected the patient’s clinical data; Yang S reviewed this paper and approved the final version of this manuscript.
Supported byChinese foundation for hepatitis prevention and control, Tianqing liver disease research fund subject, No. TQGB20210050; and Beijing Municipal Administration of Hospitals Incubating Program, No. PX2022071.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Song Yang, Doctor, PhD, Director, Doctor, Professor, Teacher, Division Third Center of Hepatology, Beijing Ditan Hospital, Capital Medical University, No.8 Jingshun East Street, Chaoyang District, Beijing 100015, China. sduyangsong@163.com
Received: July 6, 2022 Peer-review started: July 6, 2022 First decision: August 4, 2022 Revised: August 24, 2022 Accepted: September 19, 2022 Article in press: September 19, 2022 Published online: October 26, 2022 Processing time: 106 Days and 13.8 Hours
Abstract
BACKGROUND
Hepatic myelopathy (HM) is a rare neurological complication of advanced cirrhosis. Prognosis of patients with HM is generally poor without timely liver transplantation or interventional therapy. Self-resolving HM in patients with alcoholic cirrhosis has never been reported.
CASE SUMMARY
A 53-year-old man with alcoholic cirrhosis and recurrent overt hepatic encephalopathy for 1 year was admitted for lower extremity weakness, slow movement, and stumbling gait. The patient was diagnosed with HM after excluding other causes of spastic paraparesis. The patient refused liver transplantation. However, the patient kept total abstinence and received a multidisciplinary treatment for complications of decompensated cirrhosis. The symptoms of HM resolved gradually after 2 years of treatment. All complications of alcoholic cirrhosis resolved after 4 years of follow-up.
CONCLUSION
The case demonstrates that HM can resolve in patients without liver transplan-tation after total abstinence and systemic management of complications.
Core Tip: Hepatic myelopathy (HM) is a rare neurological complication of advanced cirrhosis. Prompt liver transplantation or interventional therapy may reverse the symptoms of HM. Self-resolving HM in patients with alcoholic cirrhosis has never been reported. Our report presents that self-resolving HM in a patient with alcoholic cirrhosis is possible without any liver transplantation and interventional therapy after promptly controlling the etiology and systemic management of complications. This case provides new insight into the self-remission of patients with HM.
