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.
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