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Hepatic encephalopathy is an extremely rare complication of HHT and early diagnosis and treatment can be life-saving. We present a rare case of hepatic encephalopathy caused by HHT-induced portosystemic shunting treated with lactulose.<\/jats:p>","DOI":"10.1155\/2019\/7573408","type":"journal-article","created":{"date-parts":[[2019,3,26]],"date-time":"2019-03-26T19:38:36Z","timestamp":1553629116000},"page":"1-4","source":"Crossref","is-referenced-by-count":4,"title":["Lactulose to the Rescue: A Case of Toxic Hepatic Encephalopathy Caused by Portosystemic Shunting and Epistaxis in a Patient with Hereditary Hemorrhagic Telangiectasia"],"prefix":"10.1155","volume":"2019","author":[{"given":"Ruchit N.","family":"Shah","sequence":"first","affiliation":[{"name":"Geisinger Medical Center, Department of Internal Medicine, 100 N Academy Ave, Danville, PA 17822, USA"},{"name":"Geisinger Commonwealth School of Medicine, 525 Pine Street, Scranton, PA 18510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5109-3604","authenticated-orcid":true,"given":"Michael","family":"Makar","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, 525 Pine Street, Scranton, PA 18510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasir","family":"Akhtar","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center, Department of Gastroenterology, 100 N Academy Ave, Danville, PA 17822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Forster","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center, Department of Gastroenterology, 100 N Academy Ave, Danville, PA 17822, USA"},{"name":"Medical University of South Carolina, 30 Courtenay Dr, Charleston, SC 29425, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1056\/nejm199510053331407"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001538"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410040207"},{"issue":"2","key":"4","first-page":"209","volume":"81","year":"1981","journal-title":"New York State journal of medicine"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.193003"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-1585-2"},{"journal-title":"Drugs","year":"2019","key":"7"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-813549"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2301021745"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1085093"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03775.x"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1097\/RUQ.0000000000000107"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2006.12.008"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.30.12.1134"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.176.4.1760919"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-011-0531-9"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200009283431305"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(99)70243-X"},{"issue":"9","key":"19","first-page":"948","volume":"307","year":"2012","journal-title":"Journal of the American Medical Association"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc0901421"}],"container-title":["Case Reports in Hepatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crihep\/2019\/7573408.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crihep\/2019\/7573408.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crihep\/2019\/7573408.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,3,26]],"date-time":"2019-03-26T19:38:37Z","timestamp":1553629117000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/crihep\/2019\/7573408\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,26]]},"references-count":20,"alternative-id":["7573408","7573408"],"URL":"https:\/\/doi.org\/10.1155\/2019\/7573408","relation":{},"ISSN":["2090-6587","2090-6595"],"issn-type":[{"type":"print","value":"2090-6587"},{"type":"electronic","value":"2090-6595"}],"subject":[],"published":{"date-parts":[[2019,3,26]]}}}