603 IS THERE ANY EFFECT OF THROMBOPOIETIN ON THE THROMBOCYTOPENIA WHICH RELATED WITH PORTAL HYPERTENSION?

Abstract

Background and Aims: Minimal hepatic encephalopathy is common in patients with extrahepatic portal vein obstruction (EHPVO). Lactulose is effective in the treatment of MHE in patients with cirrhosis. There is no study on the treatment of MHE using lactulose in patients with EHPVO. Patients and Methods: Consecutive EHPVO patients were assessed by psychometric [(number connection test (NCT-A and B), digit symbol test (DST), serial dot test (SDT), line tracing test (LTT)] and critical flicker frequency (CFF) at inclusion. Patients diagnosed as MHE were treated with lactulose and psychometric tests and CFF were reassessed after 3 months. Results: Of 70 patients screened prevalence of abnormal psychometric test were NCT-A (41%), NCT-B(53%), DST(38%), SDT(40%) and LTT(44%). Thirty patients (43%) had two or more than two abnormal psychometry tests. Lactulose improved MHE in 16/30(53%) of patients after 3 months of treatment. All patients could do CFF with little training.CFF in patients with MHE (n =30) was significantly lower than those without MHE (n =40) (38.1±2.4 vs 41.5±3.1Hz, p = 0.01). CFF was less than 38Hz in 21(70%) of 30 patients before treatment and in 10(33%) patients after lactulose therapy in MHE patients. All patients could tolerate lactulose without any significant side effects. Four patients (13%) developed transient diarrhea in whom dose need reduction, 3(10%) did not like its taste but still continued, 2(6%) developed abdominal bloating sensation. Conclusions: Lactulose is effective in the treatment of MHE in patients with EHPVO.