DOI: http://dx.doi.org/10.18203/2349-3933.ijam20163722

Correlation of serum ammonia with grades of hepatic encephalopathy

Rajpreet Brar, P. K. Gupta, S. K. Virmani, Gautam Sarkar

Abstract


Background: Affected patients exhibit alterations in psychomotor, intellectual, cognitive, emotional, behavioural and fine motor functions. Hepatic encephalopathy occurs as a complication of advance liver disease, either chronic or acute.

Methods: 58 patients of hepatic encephalopathy was enrolled in our study which was done in Chhatrapati Shivagi Subharti hospital for the duration of 2 years to look for the correlation of grades of hepatic encephalopathy with serum ammonia levels.

Results: In this study, the correlation of serum ammonia was significant with the grade of encephalopathy hence, the serum ammonia correlated well with the grade of encephalopathy for the patients during their hospital stay, suggesting that the serum ammonia level was an indicator of the clinical outcome of the patients during their hospital stay.

Conclusions: In this study, we found that there is a strong correlation between serum ammonia level and severity of liver disease. Higher serum ammonia was found in severe liver disease. We found that High grade i.e. grade III and IV patients were having significantly raised ammonia level.


Keywords


CLD, HE, MHE, OHE, Serum ammonia level

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References


Ferenci P. Hepatic encephalopathy-definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology. 2002;35:716-21.

Blel AT, Cordoba J. Practice guidelines: hepatic encephalopathy Am J Gastroenterol. 2001;96(7):1968-76.

Bell BP. Chronic liver disease in the United States: disease burden and epidemiology. Available at http://www2.niddk.nih.gov/NR/rdonlyres/527863FE-0F39-47A6-A04F-3A0AE929FEED/0/Bell.pdf. Accessed 03 April 2009.

Bell BP, Manos MM, Zaman A. the epidemiology of newly diagnosed chronic liver disease in gastroenterology practices in United States: results from population-based surveillance. AM J Gastroenterol. 2008;103(11):2727-36.

Ong JP. Correlation between ammonia levels and the severity of hepatic encephalopathy. Am. J. Med. 2003;114:188-93.

Clemmesen JO, Larsen FS, Kondrup J. Cerebral herniation in patients with acute liver failure is correlated with arterial ammonia concentration. Hepatology. 1999:29;648-53.

Tarantino G. Blood ammonia levels in liver cirrhosis: a clue for the presence of portosystemic collateral veins. BMC Gastroentrology. 2009;9:21.