Plasma amino acid patterns in different stages of Egyptian splenomegaly and following the commonly used surgical procedures

ABSTRACT

Plasma fasting amino acid profiles were studied among ninety patients selected and classified into 4 main groups. Group A [control group] included 20 normal subjects, with a mean age of 28.95 +/- 1.86 years. Group B included 10 patients with noncomplicated portal hypertension and a mean age of 30.6 +/- 2.4 years. Group C included 30 patients with complicated portal hypertension and classified into 3 subgroups. Subgroup I, 10 patients with ascites and a mean age of 41 +/- 3.49 years. Subgroup II, 10 patients with encephalopathy and a mean age of 48.6 +/- 3.26 years. Subgroup III, 10 patients with bleeding esophageal varices and a mean age of 34.8 +/- 1.87 years. Group D included 30 patients following 3 commonly used surgical operation used for treatment or portal hypertension. Their aminogram was assessed 3 months after operation to nulify the effect of postoperative complications. Subgroup I, 10 patients with a mean age of 26.3 +/- 2.05, for whom splenectomy was done. Subgroup II, 10 patients with a mean age of 29.6 +/- 3.07 years, for whom Hassab's operation was done. Subgroup III, 10 patients with a mean age of 26.3 +/- 1.76 years, for whom Warren's shunt was done. When compared to control group, noncomplicated cirrhotic group B showed a significant increase of aspartic acid and threonine. Group C [I] showed a significant increase of histidine, glutamic acid and threonine. Group C [II] showed a significant increase of glutamic acid, tyrosine, threonine phenylalanine and aspartic acid, and a significant decrease of leucine and isoleucine. Group C [III] showed a significant increase of threonine. Group D [I] showed a significant increase in aspartic acid and group D [II] a significant increase in threonine. Group D [III] showed a significant increase of aspartic acid, glutamic acid, phenylanine, lysine and threonine. Disturbed amino acid patterns were found among the different groups studied with a characteristic pattern among patients with hepatic encephalopathy. Among surgical approaches used for treatment of portal hypertension, shunt operation was associated with increased levels of amino acids of known deletrious effects on cerebral functions and is therefore better avoided group