A New Risk Factor for Hepatic Encephalopathy: Ingestion of Mad Honey

Abstract

Introduction: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome that occurs in the severe liver dysfunction and is characterized by a wide range of central nervous system symptoms. Hepatic encephalopathy precipitated with mostly infections, gastrointestinal bleeding, diuretic overdose, electrolyte imbalance, constipation and drugs. Traditional local foods for example honey can contain toxins for the liver and could cause acute decompensation in patients with chronic liver disease (CLD). This toxins can cause dose related severe symptoms. Spectrum of the symptoms are from nausea, vomiting to life threatening bradycardia and/or hypotension. Case Report: A 66-years-old man with prior hepatitis B-related Child-Pugh B cirrhosis admitted to the hospital with nausea, vomiting, confusion, gross disorientation and bizarre behavior. By the aid of medical history, physical examination, laboratory tests and imaging techniques; hepatic encephalopathy diagnosed with distinct aetiology, is mad honey consumption. Conclusion: In this paper; we reported first time in English literature a cirrhotic case with hepatic encephalopathy due to consumption of mad honey. words: