Hepatic encephalopathy presenting as delirium and mania. The possible role of bilirubin.
The case of a woman who suffered from hepatic encephalopathy is described. The psychiatric symptoms presented first as a delirium, changing into a manic syndrome. As the neurotoxic direct fraction of bilirubin was greater than 100 times normal, increasing and decreasing in a parallel fashion with the psychiatric symptoms, direct bilirubin is assumed to play a role in the pathogenesis of this case. This is discussed in the context of bilirubin encephalopathy, very seldom diagnosed in adults.
Psychiatric Hospital, University of Munich, Germany.
N
N
Müller
U
U
Klages
W
W
Günther
D001663:Bilirubin / Q000097:blood*; D001714:Bipolar Disorder / Q000097:blood / Q000209:etiology*; D001803:Blood Transfusion; D003693:Delirium / Q000097:blood / Q000209:etiology*; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood / Q000150:complications*; D006509:Hepatitis B / Q000097:blood / Q000150:complications; D006801:Humans; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000097:blood / Q000209:etiology*; D009483:Neuropsychological Tests
D001663:Bilirubin