Luminary Learning Gastrointestinal Disorder- Issue 1

1 Latest concepts in inpatient hepatic encephalopathy management Thoetchai (Bee) Peeraphatdit, Patrick S. Kamath, Michael D. Leise Abbreviations ACLF Acute-on-chronic liver failure BCAA Branched-chain amino acids CLIF-C ACLF Chronic Liver Failure Consortium ACLF Score DAMPs Damage-associated molecular patterns ESPEN European Society for Parenteral and Enteral Nutrition FDA Food and Drug Administration HE Hepatic encephalopathy IL Interleukin LOLA l-ornithine l-aspartate LT Liver transplant MARS Molecular adsorbent recirculating system MELD Model for end-stage liver disease PAMPs Pathogen-associated molecular patterns RCT Randomized controlled trial TIPS Transjugular intrahepatic portosystemic shunt Patient Scenario 1 A 35-year-old female with past medical history of compensated alcoholic cirrhosis presented with altered mental status after alcohol binge drinking. On physical exam, her vital signs were stable. She was only oriented to self and had marked jaundice and asterixis. Her laboratory result showed leukocyte count of 15 × 10 9 /L, creatinine of 5.7 mg/dL (with baseline of 1.0 mg/dL), aspartate ami- notransferase of 288 U/L, alanine aminotransferase of 119 U/L, alkaline phosphatase of 383 U/L, 1 T. Peeraphatdit, M.D., P. S. Kamath, M.D. (  ), M. D. Leise, M.D. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA e-mail: peeraphatdit.thoetchai@mayo.edu ; Kamath.patrick@mayo.edu ; Leise.michael@mayo.edu Continuing Education