{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T11:12:30Z","timestamp":1785928350495,"version":"3.56.0"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,11,1]],"date-time":"2012-11-01T00:00:00Z","timestamp":1351728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["5\/9\/62\/2008\u2010RHN"],"award-info":[{"award-number":["5\/9\/62\/2008\u2010RHN"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives:<\/jats:title><jats:p>This prospective, sequential study was done to understand changes in cerebral edema (CE) on magnetic resonance imaging and magnetic resonance spectroscopy, liver functions, and neurocognitive testing (NCT) in children with acute liver failure (ALF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>A total of 11 ALF and 8 healthy controls were evaluated with advanced magnetic resonance (MR) imaging, blood proinflammatory cytokines (PCs), thiamine levels, liver functions, and NCT. Reevaluation was done at 43.5 \u00b1 26.9 days (first follow\u2010up, n = 8) and 157.3 \u00b1 52.3 days (second follow\u2010up, n = 6) after discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>At diagnosis, patients with ALF had vasogenic and cytotoxic CE, raised brain glutamine (23.2 \u00b1 3.4 vs 15.3 \u00b1 2.7), and serum PCs (tumor necrosis factor [TNF]\u2010\u03b1 40.1 \u00b1 8.9 vs 7.2 \u00b1 2.7 pg\/mL, interleukin [IL]\u20106 29.2 \u00b1 14.4 vs 4.7 \u00b1 1.2 pg\/mL). The mammillary bodies (MBs) were smaller, and brain choline (1.9 \u00b1 0.36 vs 2.6 \u00b1 0.6) and blood thiamine (55.2 \u00b1 6.7 vs 81.8 \u00b1 10.2 nmol\/L) were lower than controls. At first follow\u2010up, the brain glutamine and CE recovered. Brain choline and MBs volume showed improvement and thiamine levels normalized. Significant reduction in TNF\u2010\u03b1 and IL\u20106 was seen. The patients performed poorly on NCT, which normalized at second follow\u2010up. Liver biochemistry and thiamine levels were normal and TNF\u2010\u03b1 and IL\u20106 showed further reduction at second follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Patients with ALF have CE contributed by raised brain glutamine and PCs. MBs are small because of thiamine deficiency and show recovery in follow\u2010up. CE and brain glutamine recover earlier than normalization of NCT and liver functions. Persistence of raised cytokines up to 6 months after insult suggests possible contribution from liver regeneration.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e31825f4c3e","type":"journal-article","created":{"date-parts":[[2012,5,18]],"date-time":"2012-05-18T13:53:37Z","timestamp":1337349217000},"page":"580-586","source":"Crossref","is-referenced-by-count":15,"title":["Serial Evaluation of Children With ALF With Advanced MRI, Serum Proinflammatory Cytokines, Thiamine, and Cognition Assessment"],"prefix":"10.1002","volume":"55","author":[{"given":"Anshu","family":"Srivastava","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh K.","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Radiology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow 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CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram K.S.","family":"Rathore","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics Indian Institute of Technology Kanpur Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandra M.","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh K.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Radiology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow 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