title: Factors contributing to the development of overt encephalopathy in liver cirrhosis patients.
abstract: The aim of this study was to clarify the relationships among psychometric testing results, blood ammonia (NH3) levels, electrolyte abnormalities, and degree of inflammation, and their associations with the development of overt hepatic encephalopathy (HE) in liver cirrhosis (LC) patients. The relationships between covert HE and blood NH3, sodium (Na), and C-reactive protein (CRP) were examined in 40 LC patients. The effects of elevated NH3, hyponatremia, and elevated CRP on the development of overt HE were also investigated. The covert HE group had significantly lower serum Na levels and significantly higher serum CRP levels. During the median observation period of 11 months, 10 patients developed overt HE, and the results of multivariate analysis showed that covert HE and elevated blood NH3 were factors contributing to the development of overt HE. Electrolyte abnormalities and mild inflammation are involved in the pathogenesis of HE. Abnormal psychometric testing results and hyperammonemia are linked to subsequent development of overt HE.
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan. motoh@clin.medic.mie-u.ac.jp.
authors.forename: Motoh
authors.initials: M
authors.lastname: Iwasa
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Sugimoto
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Rumi
authors.initials: R
authors.lastname: Mifuji-Moroka
authors.affiliation: Nutrition Unit, Mie University Hospital, Tsu, Japan.
authors.forename: Nagisa
authors.initials: N
authors.lastname: Hara
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Yoshikawa
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Eguchi
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hasegawa
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
mesh_terms: D000368:Aged; D000641:Ammonia / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006501:Hepatic Encephalopathy / Q000097:blood* / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D000641:Ammonia; D002097:C-Reactive Protein
keywords: Ammonia; Hepatic encephalopathy; Hyponatremia; Inflammation; Liver cirrhosis