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Abstract Details
Hepatic Encephalopathy-A Guide to Laboratory Testing
Clin Liver Dis. 2024 May;28(2):225-236. doi: 10.1016/j.cld.2024.01.003.Epub 2024 Jan 30.
1Department of Gastroenterology, California Pacific Medical Center.
2Division of Hepatology, Department of Advanced Organ Therapies, California Pacific Medical Center. Electronic address: todd.frederick@sutterhealth.org.
Abstract
Hepatic encephalopathy (HE) remains both a clinical diagnosis and one of exclusion. Laboratory testing is largely focused on identifying precipitating factors. Ammonia levels in the blood can be helpful for the diagnosis of HE but are not required for confirmation. More recent literature is lending support to the prognostic capabilities of ammonia in cirrhosis, both in predicting future HE events and in determining outcomes in hospitalized patients. Accurate ammonia testing requires strict protocols to avoid common pitfalls in the measurement of this labile analyte. Future studies investigating the utility of other laboratory testing to diagnose, stage, or predict HE are encouraged.