Hepatic encephalopathy laboratory findings: Difference between revisions
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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> | ||
==Psychometric testing== | |||
The number connection test of Rietan may be helpful.<ref name="pmid9566834">{{cite journal| author=Weissenborn K, Rückert N, Hecker H, Manns MP| title=The number connection tests A and B: interindividual variability and use for the assessment of early hepatic encephalopathy. | journal=J Hepatol | year= 1998 | volume= 28 | issue= 4 | pages= 646-53 | pmid=9566834 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9566834 }} </ref> | |||
The inhibitory control test (ICT) may be a faster way to diagnose hepatic encephalopathy than standard psychometric tests (average administration time of 15 minutes versus 37 minutes).<ref name="pmid17222319">{{cite journal |author=Bajaj JS, Saeian K, Verber MD, ''et al'' |title=Inhibitory control test is a simple method to diagnose minimal hepatic encephalopathy and predict development of overt hepatic encephalopathy |journal=Am. J. Gastroenterol. |volume=102 |issue=4 |pages=754-60 |year=2007 |pmid=17222319 |doi=10.1111/j.1572-0241.2007.01048.x}}</ref> | The inhibitory control test (ICT) may be a faster way to diagnose hepatic encephalopathy than standard psychometric tests (average administration time of 15 minutes versus 37 minutes).<ref name="pmid17222319">{{cite journal |author=Bajaj JS, Saeian K, Verber MD, ''et al'' |title=Inhibitory control test is a simple method to diagnose minimal hepatic encephalopathy and predict development of overt hepatic encephalopathy |journal=Am. J. Gastroenterol. |volume=102 |issue=4 |pages=754-60 |year=2007 |pmid=17222319 |doi=10.1111/j.1572-0241.2007.01048.x}}</ref> | ||
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Overview
Laboratory Findings
Tests may include:
- Complete blood count or hematocrit to check for anemia
- Liver function tests
- Prothrombin time
- Serum ammonia levels
- Sodium level in the blood
- Potassium level in the blood
- BUN and creatinine to see how the kidneys are working
An ammonia level more than 200 strongly suggests hepatic encephalopathy.[1]
Ammonia levels over 123 are likely to improve with lactulose therapy.[2]
Psychometric testing
The number connection test of Rietan may be helpful.[3]
The inhibitory control test (ICT) may be a faster way to diagnose hepatic encephalopathy than standard psychometric tests (average administration time of 15 minutes versus 37 minutes).[4]
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.
- ↑ Weissenborn K, Rückert N, Hecker H, Manns MP (1998). "The number connection tests A and B: interindividual variability and use for the assessment of early hepatic encephalopathy". J Hepatol. 28 (4): 646–53. PMID 9566834.
- ↑ Bajaj JS, Saeian K, Verber MD; et al. (2007). "Inhibitory control test is a simple method to diagnose minimal hepatic encephalopathy and predict development of overt hepatic encephalopathy". Am. J. Gastroenterol. 102 (4): 754–60. doi:10.1111/j.1572-0241.2007.01048.x. PMID 17222319.