Abstract

LOPEZ, Alejandra; CHAVARRIA, Roberto  and  OVIEDO, Gabriel. Therapeutic dilemma: alcohol withdrawal syndrome and concurrent hepatic encephalopathy. A case report. rev.colomb.psiquiatr. [online]. 2021, vol.50, n.1, pp.52-56.  Epub May 18, 2021. ISSN 0034-7450.  https://doi.org/10.1016/j.rcp.2019.10.002.

Alcohol use disorder is one of the main causes of morbidity and mortality in the world. Alcoholic liver disease is a common complication of this disorder, and hepatic encephalopathy is a serious complication of alcoholic cirrhosis. Precipitating factors may be related to infection, gastrointestinal bleeding, dehydration or the effects of psychotropic drugs (e.g. benzodiazepines and non-benzodiazepine hypnotics). We present a case of the hospital management of a patient with a severe alcohol use disorder, cirrhosis and hepatic encephalopathy who developed alcohol withdrawal symptoms while in hospital, and discuss the complexity of the antagonistic management of a GABAergic delirium characteristic of hepatic encephalopathy in the context of a glutamatergic-noradrenergic delirium due to alcohol withdrawal.

Keywords : Hepatic encephalopathy; Alcohol withdrawal; Delirium tremens; CIWA-Ar.

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