WERNICKE’S ENCEPHALOPATHY IN PEDIATRIC PATIENTS AFTER LIVER TRANSPLANT SURGERY: CLINICAL CASE REPORT

Pediatric liver transplantation has become increasingly important in the management of chronic liver diseases in children. During the postoperative intensive care period, several risk factors may impair absorption and alter the metabolism of essential vitamins, including vitamin B1. Deficiency of vitamin B1 can lead to Wernicke encephalopathy, which often presents clinically in a manner similar to acute encephalopathy. In this report, we describe a case of a 6-year-old girl who underwent living-donor liver transplantation from an unrelated donor. Nineteen days after surgery, the patient developed seizures accompanied by a decreased level of consciousness. Brain MRI revealed hyperintense lesions around the aqueduct and in the occipital region. After excluding other potential causes of impaired consciousness, blood samples were obtained for vitamin B1 quantification and the patient was administered intramuscular vitamin B1. Within two days of treatment, the patient showed marked neurological improvement and complete cessation of seizures. Subsequent testing confirmed a severe deficiency of vitamin B1. This is a rare and easily overlooked complication after liver transplantation.