The Effect of Fecal Microbiota Transplantation on Hepatic Myelopathy: A Case Report

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2019 Jul 16

PMID 31305466

Citations 8

Authors

Lin Sun

Jun Li

Li-Li Lan

Xiao-An Li

Affiliations

Soon will be listed here.

Abstract

Rationale: Hepatic myelopathy (HM), also known as portal-systemic myelopathy, is a rare neurological complication that occurs in patients with chronic liver disease. There is no easy and feasible treatment, liver transplantation is the only accepted therapy that may be effective for patients at early stage at present. The pathogenesis of the disease is not clear yet, and the prognosis is poor. Here we describe a reversible HM after fecal microbiota transplantation.

Patient Concerns: In this report, a middle-aged female patient with hepatitis B cirrhosis, occurred HM after transjugular intrahepatic portosystemic shunt, a progressive spastic paraparesis in both legs were the main symptoms.

Diagnosis: The patient was diagnosed with HM.

Interventions: The patient received 3 times of fecal microbiota transplantations (FMT).

Outcomes: The patient's muscle strength of both legs were increased at various degrees, the patient's condition improved from HM2 to HM1.

Lessons: FMT may be another effective way to treat HM. It is cheaper, more operable, and simpler than the approved treatment and worthy of further research.

Citing Articles

Liver transplantation and comprehensive rehabilitation in the reversal of hepatic myelopathy: a case report.

Liu M, Wang R, Zhou W, Tian C, Wang Q, Zhang Q Front Med (Lausanne). 2024; 11:1467611.

PMID: 39600935 PMC: 11588450. DOI: 10.3389/fmed.2024.1467611.

Hepatic myelopathy neurological complication of chronic liver disease: two case reports.

Mhiri M, Ben Abdelwahed M, Dhiflaoui M, Ben Dhia R, Gouta N, Jemni I J Med Case Rep. 2024; 18(1):281.

PMID: 38880918 PMC: 11181619. DOI: 10.1186/s13256-024-04495-2.

Liver Transplantation Reverses Hepatic Myelopathy in the Decompensated Phase of Cirrhosis: Case Report and Literature Review.

Li J, Wan S, Wen F, Li Q, Cui Y, Lu Z J Clin Transl Hepatol. 2024; 12(4):436-442.

PMID: 38638382 PMC: 11022064. DOI: 10.14218/JCTH.2023.00487.

Ethanol-Producing Is Enriched in Chronic Hepatitis B-Associated Gut Dysbiosis: A Case-Control Culturomics Study.

Wasfy R, Mbaye B, Borentain P, Alou M, Murillo Ruiz M, Caputo A Microorganisms. 2023; 11(10).

PMID: 37894093 PMC: 10608849. DOI: 10.3390/microorganisms11102437.

Spontaneous remission of hepatic myelopathy in a patient with alcoholic cirrhosis: A case report.

Chang C, Liu C, Duan F, Zhai H, Song S, Yang S World J Clin Cases. 2022; 10(30):11172-11177.

PMID: 36338225 PMC: 9631124. DOI: 10.12998/wjcc.v10.i30.11172.

References

Kazemi A, Noorbala A, Azam K, Eskandari M, Djafarian K . Effect of probiotic and prebiotic vs placebo on psychological outcomes in patients with major depressive disorder: A randomized clinical trial. Clin Nutr. 2018; 38(2):522-528. DOI: 10.1016/j.clnu.2018.04.010. View

Deshmukh H, Liu Y, Menkiti O, Mei J, Dai N, OLeary C . The microbiota regulates neutrophil homeostasis and host resistance to Escherichia coli K1 sepsis in neonatal mice. Nat Med. 2014; 20(5):524-30. PMC: 4016187. DOI: 10.1038/nm.3542. View

Zhuang Z, Shen L, Li W, Fu X, Zeng F, Gui L . Gut Microbiota is Altered in Patients with Alzheimer's Disease. J Alzheimers Dis. 2018; 63(4):1337-1346. DOI: 10.3233/JAD-180176. View

Mullish B, McDonald J, Thursz M, Marchesi J . Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial. Hepatology. 2017; 66(4):1354-1355. DOI: 10.1002/hep.29369. View

Shyu W, Lin S, Yang H, Tzeng Y, Pang C, Yen P . Functional recovery of stroke rats induced by granulocyte colony-stimulating factor-stimulated stem cells. Circulation. 2004; 110(13):1847-54. DOI: 10.1161/01.CIR.0000142616.07367.66. View

Bellocchi C, Volkmann E . Update on the Gastrointestinal Microbiome in Systemic Sclerosis. Curr Rheumatol Rep. 2018; 20(8):49. DOI: 10.1007/s11926-018-0758-9. View

Giangaspero F, Dondi C, Scarani P, Zanetti G, Marchesini G . Degeneration of the corticospinal tract following portosystemic shunt associated with spinal cord infarction. Virchows Arch A Pathol Anat Histopathol. 1985; 406(4):475-81. DOI: 10.1007/BF00710238. View

Erny D, Hrabe de Angelis A, Jaitin D, Wieghofer P, Staszewski O, David E . Host microbiota constantly control maturation and function of microglia in the CNS. Nat Neurosci. 2015; 18(7):965-77. PMC: 5528863. DOI: 10.1038/nn.4030. View

Kelly C, Khoruts A, Staley C, Sadowsky M, Abd M, Alani M . Effect of Fecal Microbiota Transplantation on Recurrence in Multiply Recurrent Clostridium difficile Infection: A Randomized Trial. Ann Intern Med. 2016; 165(9):609-616. PMC: 5909820. DOI: 10.7326/M16-0271. View

10.

Ben Amor S, Saied M, Harzallah M, Benammou S . Hepatic myelopathy with spastic paraparesis: report of two cases and review of the literature. Eur Spine J. 2013; 23 Suppl 2:167-71. DOI: 10.1007/s00586-013-2828-z. View

11.

Tilg H, Moschen A . Microbiota and diabetes: an evolving relationship. Gut. 2014; 63(9):1513-21. DOI: 10.1136/gutjnl-2014-306928. View

12.

di Biase L, Picillo M, Freitas M, Bui E, Fasano A . Hepatitis C Virus-Related Hepatic Myelopathy After Treatment With Sofosbuvir and Ribavirin: A Case Report. Ann Intern Med. 2017; 166(5):379-380. DOI: 10.7326/L16-0038. View

13.

Baccarani U, Zola E, Adani G, Cavalletti M, Schiff S, Cagnin A . Reversal of hepatic myelopathy after liver transplantation: fifteen plus one. Liver Transpl. 2010; 16(11):1336-7. DOI: 10.1002/lt.22149. View

14.

Morkl S, Lackner S, Meinitzer A, Mangge H, Lehofer M, Halwachs B . Gut microbiota, dietary intakes and intestinal permeability reflected by serum zonulin in women. Eur J Nutr. 2018; 57(8):2985-2997. PMC: 6267414. DOI: 10.1007/s00394-018-1784-0. View

15.

Braniste V, Al-Asmakh M, Kowal C, Anuar F, Abbaspour A, Toth M . The gut microbiota influences blood-brain barrier permeability in mice. Sci Transl Med. 2014; 6(263):263ra158. PMC: 4396848. DOI: 10.1126/scitranslmed.3009759. View

16.

Sun M, Zhu Y, Zhou Z, Jia X, Xu Y, Yang Q . Neuroprotective effects of fecal microbiota transplantation on MPTP-induced Parkinson's disease mice: Gut microbiota, glial reaction and TLR4/TNF-α signaling pathway. Brain Behav Immun. 2018; 70:48-60. DOI: 10.1016/j.bbi.2018.02.005. View

17.

Li S, Lv J, Li J, Zhao Z, Guo H, Zhang Y . Intestinal microbiota impact sepsis associated encephalopathy via the vagus nerve. Neurosci Lett. 2017; 662:98-104. DOI: 10.1016/j.neulet.2017.10.008. View

18.

Dantzer R, Konsman J, Bluthe R, Kelley K . Neural and humoral pathways of communication from the immune system to the brain: parallel or convergent?. Auton Neurosci. 2001; 85(1-3):60-5. DOI: 10.1016/S1566-0702(00)00220-4. View

19.

Ferrere G, Wrzosek L, Cailleux F, Turpin W, Puchois V, Spatz M . Fecal microbiota manipulation prevents dysbiosis and alcohol-induced liver injury in mice. J Hepatol. 2016; 66(4):806-815. DOI: 10.1016/j.jhep.2016.11.008. View

20.

Routy B, Gopalakrishnan V, Daillere R, Zitvogel L, Wargo J, Kroemer G . The gut microbiota influences anticancer immunosurveillance and general health. Nat Rev Clin Oncol. 2018; 15(6):382-396. DOI: 10.1038/s41571-018-0006-2. View