Hepatic encephalopathy laboratory findings: Difference between revisions
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==Laboratory Findings== | ==Laboratory Findings== | ||
An [[ammonia]] level more than 200 strongly suggests hepatic encephalopathy.<ref name="pmid12637132">{{cite journal| author=Ong JP, Aggarwal A, Krieger D, Easley KA, Karafa MT, Van Lente F et al.| title=Correlation between ammonia levels and the severity of hepatic encephalopathy. | journal=Am J Med | year= 2003 | volume= 114 | issue= 3 | pages= 188-93 | pmid=12637132 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12637132 }} </ref> | An [[ammonia]] level more than 200 strongly suggests hepatic encephalopathy.<ref name="pmid12637132">{{cite journal| author=Ong JP, Aggarwal A, Krieger D, Easley KA, Karafa MT, Van Lente F et al.| title=Correlation between ammonia levels and the severity of hepatic encephalopathy. | journal=Am J Med | year= 2003 | volume= 114 | issue= 3 | pages= 188-93 | pmid=12637132 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12637132 }} </ref> | ||
[[Ammonia]] levels over 123 are likely to improve with lactulose therapy.<ref name="pmid19555401">{{cite journal| author=Sharma P, Sharma BC, Sarin SK| title=Predictors of nonresponse to lactulose for minimal hepatic encephalopathy in patients with cirrhosis. | journal=Liver Int | year= 2009 | volume= 29 | issue= 9 | pages= 1365-71 | pmid=19555401 | doi=10.1111/j.1478-3231.2009.02067.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19555401 }} </ref> | [[Ammonia]] levels over 123 are likely to improve with [[lactulose]] therapy.<ref name="pmid19555401">{{cite journal| author=Sharma P, Sharma BC, Sarin SK| title=Predictors of nonresponse to lactulose for minimal hepatic encephalopathy in patients with cirrhosis. | journal=Liver Int | year= 2009 | volume= 29 | issue= 9 | pages= 1365-71 | pmid=19555401 | doi=10.1111/j.1478-3231.2009.02067.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19555401 }} </ref> | ||
Other | Other important laboratory findings in hepatic encephalopathy may include: | ||
*[[Hyponatremia]]<ref name="pmid19455127">{{cite journal| author=Yun BC, Kim WR| title=Hyponatremia in hepatic encephalopathy: an accomplice or innocent bystander? | journal=Am J Gastroenterol | year= 2009 | volume= 104 | issue= 6 | pages= 1390-1 | pmid=19455127 | doi=10.1038/ajg.2009.287 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19455127 }} </ref> | *[[Hyponatremia]]<ref name="pmid19455127">{{cite journal| author=Yun BC, Kim WR| title=Hyponatremia in hepatic encephalopathy: an accomplice or innocent bystander? | journal=Am J Gastroenterol | year= 2009 | volume= 104 | issue= 6 | pages= 1390-1 | pmid=19455127 | doi=10.1038/ajg.2009.287 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19455127 }} </ref> | ||
*[[Hypokalemia]]<ref name="pmid25436277">{{cite journal| author=Gaduputi V, Chandrala C, Abbas N, Tariq H, Chilimuri S, Balar B| title=Prognostic significance of hypokalemia in hepatic encephalopathy. | journal=Hepatogastroenterology | year= 2014 | volume= 61 | issue= 133 | pages= 1170-4 | pmid=25436277 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25436277 }} </ref> | *[[Hypokalemia]]<ref name="pmid25436277">{{cite journal| author=Gaduputi V, Chandrala C, Abbas N, Tariq H, Chilimuri S, Balar B| title=Prognostic significance of hypokalemia in hepatic encephalopathy. | journal=Hepatogastroenterology | year= 2014 | volume= 61 | issue= 133 | pages= 1170-4 | pmid=25436277 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25436277 }} </ref> | ||
*Anemia is a predictor of hepatic | *Anemia is a predictor of hepatic encephalopathy in some patients with [[Cirrhosis|hepatic cirrhosis]].<ref name="pmid23452072">{{cite journal| author=Kalaitzakis E, Josefsson A, Castedal M, Henfridsson P, Bengtsson M, Andersson B et al.| title=Hepatic encephalopathy is related to anemia and fat-free mass depletion in liver transplant candidates with cirrhosis. | journal=Scand J Gastroenterol | year= 2013 | volume= 48 | issue= 5 | pages= 577-84 | pmid=23452072 | doi=10.3109/00365521.2013.777468 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23452072 }} </ref> | ||
*[[Liver function tests]]: patients may have abnormal bilirubin, albumin, AST, ALT, AST/ALT, INR due to hepatic disease.<ref name="pmid28680841">{{cite journal| author=Djiambou-Nganjeu H| title=Hepatic Encephalopathy in Liver Cirrhosis. | journal=J Transl Int Med | year= 2017 | volume= 5 | issue= 1 | pages= 64-67 | pmid=28680841 | doi=10.1515/jtim-2017-0013 | pmc=5490964 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28680841 }} </ref> | *[[Liver function tests]]: patients may have abnormal [[bilirubin]], [[albumin]], [[Aspartate transaminase|AST]], [[Alanine transaminase|ALT]], [[Aspartate transaminase|AST]]/[[Alanine transaminase|ALT]], [[INR]] due to underlying hepatic disease.<ref name="pmid28680841">{{cite journal| author=Djiambou-Nganjeu H| title=Hepatic Encephalopathy in Liver Cirrhosis. | journal=J Transl Int Med | year= 2017 | volume= 5 | issue= 1 | pages= 64-67 | pmid=28680841 | doi=10.1515/jtim-2017-0013 | pmc=5490964 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28680841 }} </ref> | ||
* | *Hyper[[creatine]]<nowiki/>mia may be present in patients with end-stage [[Liver diseases|liver disease.]]<ref name="pmid22791939">{{cite journal| author=Hartleb M, Gutkowski K| title=Kidneys in chronic liver diseases. | journal=World J Gastroenterol | year= 2012 | volume= 18 | issue= 24 | pages= 3035-49 | pmid=22791939 | doi=10.3748/wjg.v18.i24.3035 | pmc=3386317 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22791939 }} </ref> | ||
==References== | ==References== | ||
Revision as of 18:55, 26 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
OR
Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
OR
[Test] is usually normal among patients with [disease name].
OR
Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
OR
There are no diagnostic laboratory findings associated with [disease name].
Laboratory Findings
- There are no diagnostic laboratory findings associated with [disease name].
OR
- An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
- [Test] is usually normal among patients with [disease name].
- Laboratory findings consistent with the diagnosis of [disease name] include:
- [Abnormal test 1]
- [Abnormal test 2]
- [Abnormal test 3]
- Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
Laboratory Findings
An ammonia level more than 200 strongly suggests hepatic encephalopathy.[1]
Ammonia levels over 123 are likely to improve with lactulose therapy.[2]
Other important laboratory findings in hepatic encephalopathy may include:
- Anemia is a predictor of hepatic encephalopathy in some patients with hepatic cirrhosis.[5]
- Liver function tests: patients may have abnormal bilirubin, albumin, AST, ALT, AST/ALT, INR due to underlying hepatic disease.[6]
- Hypercreatinemia may be present in patients with end-stage liver disease.[7]
References
- ↑ Ong JP, Aggarwal A, Krieger D, Easley KA, Karafa MT, Van Lente F; et al. (2003). "Correlation between ammonia levels and the severity of hepatic encephalopathy". Am J Med. 114 (3): 188–93. PMID 12637132.
- ↑ Sharma P, Sharma BC, Sarin SK (2009). "Predictors of nonresponse to lactulose for minimal hepatic encephalopathy in patients with cirrhosis". Liver Int. 29 (9): 1365–71. doi:10.1111/j.1478-3231.2009.02067.x. PMID 19555401.
- ↑ Yun BC, Kim WR (2009). "Hyponatremia in hepatic encephalopathy: an accomplice or innocent bystander?". Am J Gastroenterol. 104 (6): 1390–1. doi:10.1038/ajg.2009.287. PMID 19455127.
- ↑ Gaduputi V, Chandrala C, Abbas N, Tariq H, Chilimuri S, Balar B (2014). "Prognostic significance of hypokalemia in hepatic encephalopathy". Hepatogastroenterology. 61 (133): 1170–4. PMID 25436277.
- ↑ Kalaitzakis E, Josefsson A, Castedal M, Henfridsson P, Bengtsson M, Andersson B; et al. (2013). "Hepatic encephalopathy is related to anemia and fat-free mass depletion in liver transplant candidates with cirrhosis". Scand J Gastroenterol. 48 (5): 577–84. doi:10.3109/00365521.2013.777468. PMID 23452072.
- ↑ Djiambou-Nganjeu H (2017). "Hepatic Encephalopathy in Liver Cirrhosis". J Transl Int Med. 5 (1): 64–67. doi:10.1515/jtim-2017-0013. PMC 5490964. PMID 28680841.
- ↑ Hartleb M, Gutkowski K (2012). "Kidneys in chronic liver diseases". World J Gastroenterol. 18 (24): 3035–49. doi:10.3748/wjg.v18.i24.3035. PMC 3386317. PMID 22791939.