HEPATIC ENCEPHALOPATHY IN AN ONCOLOGICAL PATIENT TREATED WITH IMATINIB

Hepatic encephalopathy is a neuropsychiatric syndrome characterized by the exposure of the brain to high concentrations of toxic substances, especially ammonium. Clinically it occurs in the form of cognitive-behavioral deterioration that could lead to coma in the most advanced cases. The triggers include: previous liver alterations, bacterial injections, renal failure. constipation, psychoactive drugs, etc. We present the case of a 66-year-old male with a history of benign prostatic hyperplasia and frequent urinary tract infections, diagnosed with an inoperable gastrointestinal stromal tumor under treatment with imatinib, which required a dosage increase due to tumor progression within two months of starting therapy. Due to severe abdominal pain refractory to the first analgesic stage, it was indicated transdermal fentanyl in a palliative care consultation. After five days, the patient attended the emergency services as a result of a decreased level of consciousness, urinary tract infection and prolonged constipation related to the fentanyl patches. He was diagnosed with grade hepatic encephalopathy.