Role of Synergism in the Pathogenesis of Hepatic Encephalopathy

  • L. Zieve


My thesis is that the accumulation of certain toxins having synergistic interactions with each other lead to the development of hepatic encephalopathy, and that other endogenous abnormalities augment the toxicity of these substances (Figure 1). Four of the substances that accumulate during hepatic failure have been shown unequivocally to cause coma in experimental animals. These are ammonia, mercaptans, fatty acids, and phenols. The role of ammonia in human HE is well recognized, and has been discussed (see chapter by Schenker). However, ammonia excess alone cannot entirely account for the encephalopathy seen in a typical case, though it is an important factor.1


Hepatic Encephalopathy Hepatic Failure Synergistic Interaction Fulminant Hepatic Failure Octanoic Acid 
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Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • L. Zieve
    • 1
  1. 1.Hennepin County Medical CenterUniversity of MinnesotaMinneapolisUSA

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