The effect of fecal microbiota transplantation on Hepatic myelopathy A case report

Rationale: Hepatic myelopathy (HM), also known as portal-systemic myelopathy, is a rare neurological complication that occurs in patients with chronic liver disease. There is no easy and feasible treatment, liver transplantation is the only accepted therapy that may be effective for patients at early stage at present. The pathogenesis of the disease is not clear yet, and the prognosis is poor. Here we describe a reversible HM after fecal microbiota transplantation. Patient concerns: In this report, a middle-aged female patient with hepatitis B cirrhosis, occurred HM after transjugular intrahepatic portosystemic shunt, a progressive spastic paraparesis in both legs were the main symptoms. Diagnosis: The patient was diagnosed with HM. Interventions: The patient received 3 times of fecal microbiota transplantations (FMT). Outcomes: The patient's muscle strength of both legs were increased at various degrees, the patient's condition improved from HM2 to HM1. Lessons: FMT may be another effective way to treat HM. It is cheaper, more operable, and simpler than the approved treatment and worthy of further research.