Serum level of tumor necrosis factor-alpha in patients with hepatic encephalopathy due to chronic liver diseases

ABSTRACT

Tumor necrosis factor-alpha [TNF-alpha] is involved in many acute and chronic liver disease [CLD]. This work was conducted on 69 patients with CLD [50 patients with overt hepatic encephalopathy [HE] and 19 patients with no evidence of HE] and 13 healthy subjects as a control group. The aim was to assess the serum level TNF-alpha in patients with HE due CLD and to correlate this level with the severity and precipitating factors of HE. All patients and control subjects were subjected to clinical, laboratory and abdominal ultrasonography in addition to measurement of serum level of TNF-alpha. HE was more common in male patients [P<0.002] but not related to the age [P = 0.826]. Serum TNF- alpha level was significantly elevated in patients with CLD in comparison with the control and patients with overt HE than those with no evidence of HE [16.88 pg/ml. 33.85 pg/ml and 78.48 pg/ml] respectively. TNF-alpha was positively correlated to the synthetic liver function but not related to the liver enzyme levels. TNF-alpha was positively related to the severity of liver disease represented by Child-Pugh score [P<0.001] being highest in Child C patients. The serum level of TNF-alpha was significantly correlated to the severity of HE reaching its highest levels in Grade IV. but not related to the precipitating factors of HE. serum level of TNF-alpha was higher in cirrhotic patients with HE and correlates with severity but not the precipitating factors of HE