Hepatic encephalopathy An imbalance between aromatic amino acids (phenylalanine, tryptophan and tyrosine) and branched-chain amino acids (leucine, isoleucine and valine) has been described; this would lead to the generation of false neurotransmitters (such octopamine and 2-hydroxyphenethylamine). Dysregulation of the serotonin system, too, has been reported. Depletion of zinc and accumulation of manganese may play a role. Inflammation elsewhere in the body may precipitate encephalopathy through the action of cytokines and bacterial lipopolysaccharide on astrocytes. The diagnosis of hepatic encephalopathy can only be made in the presence of confirmed liver disease (types A and C) or a portosystemic shunt (type B), as its
Organ of Zuckerkandl Organ of Zuckerkandl The organ of Zuckerkandl is a chromaffin body derived from neural crest located at the bifurcation of the aorta or at the origin of the inferior mesenteric artery. It can be the source of a paraganglioma. The term para-aortic body is also sometimes used to describe it, as it usually arises near the abdominal aorta, but this term can be the source of confusion, because the term "corpora paraaortica" is also used to describe the aortic body, which arises near the thoracic aorta. This diffuse group of neuroendocrine sympathetic fibres was first described by Emil Zuckerkandl, a