Serum ammonia level in hepatic encephalopathy a clinical study of 35 cases

ABSTRACT

1. To determine the diagnostic significance of Serum Ammonia in Hepatic encephalopathy. 2. To correlate serum Ammonia level with clinical severity of hepatic encephalopathy. Design: A descriptive study of 23 patients of either sex between ages 13-80 years. Settings Medical Unit IV, Civil Hospital Karachi. Subjects and Methodology: Patients suffering from hepatic encephalopathy and having an underlying acute of chronic liver disease. The diagnosis was made on history, clinical findings and laboratory parameters. Serum Ammonia was estimated by sigma method [N range 17-80 ug/dl]. Main outcome measures: Hyperammonemia in relation to level of consciousness and its impact on final outcome of treatment. Majority of our patients, [82.85%] had hyperammonemia. Patients with chronic liver disease, with ascites and with hypoalbuminemia had higher levels. No age related effect was noted but females had higher serum ammonia levels. However S. Ammonia level did not correlate well with the severity and final outcome of encephalopathy. 1. Serum Ammonia estimation is helpful in the diagnosis of hepatic encephalopathy and differential diagnosis of unexplained coma. 2. It's level had no correlation with clinical severity of hepatic encephalopathy