Advertisement

Treatment of Hepatic Encephalopathy by Infusion of a Modified Amino Acid Solution: Results of a Controlled Study in 47 Cirrhotic Patients

  • H. Michel
  • G. Pomier-Layrargues
  • J. P. Aubin
  • P. Bories
  • D. Mirouze
  • H. Bellet-Hermann

Abstract

The mechanism of hepatic encephalopathy (HE) is still unknown. A characteristic amino acid pattern in HE has been described: an increased level of plasma free tryptophan, a fall in plasma branched chain amino acids (BCAA) valine, leucine and isoleucine and a rise in plasma aromatic amino acids (AAA) phenylalanine and tyrosine.1 The brain uptake of AAA would increase; the ensuing depletion of brain dopamine and norepinephrine and increase of brain octopamine, which is considered as a false neurotransmitter, would result in perturbation of cerebral neurotransmission.2

Keywords

Hepatic Encephalopathy Cirrhotic Patient Aromatic Amino Acid Branch Chain Amino Acid Spontaneous Bacterial Peritonitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    H. M. Rosen, N. Yoshimura, J. M. Hodgman, and J. E. Fischer, Plasma amino acid patterns in hepatic encephalopathy of differing etiology, Gastroenterology 72: 483 (1977).PubMedGoogle Scholar
  2. 2.
    J. E. Fischer and R. J. Baldessarini, False neurotransmitters and hepatic failure, Lancet 2: 75 (1971).PubMedCrossRefGoogle Scholar
  3. 3.
    J. E. Fischer, H. M. Rosen, A. M. Ebeid, H. J. James, J. M. Keane, and P. B. Soeters, The effects of normalization of plasma amino acids on hepatic encephalopathy in man, Surgery 80: 77 (1976).PubMedGoogle Scholar
  4. 4.
    A. Watanabe, A. Takesue, T. Higashi, and N. Nagashima, Serum amino acids in hepatic encephalopathy. Effects of branched chain amino acid infusion on serum aminogram, Acta HepatoGastroenterol. 26: 346 (1979).Google Scholar
  5. 5.
    A. Sieg, U. Gartner, J. P. Striebel, G. Lanzinger-Rossnagel, B. Kommerell, and P. Czygan, Parenterale amino saiirenbehandlung bei patient en mit leberzirrhose, Inn. Med. 6: 209 (1979).Google Scholar
  6. 6.
    T. Caparros Fernandez De Aguilar, J. Lopez Martinez, and F. Perez Picuoto, Nutricion parenteral en 29 enfermos afectos de encefalopatia hepatica tratados con F080, Rev. Clin. Esp. 155: 355 (1979).Google Scholar
  7. 7.
    G. Kleinberger, R. Kotzaurek, H. Pall, M. Pichler, and S. Szeless, Parenterale erährung bei coma hepaticum, Leber. Mogen. Darim. 6: 340 (1976).Google Scholar
  8. 8.
    P. Ferenci and F. Wewalka, Parenterale ernährung von patienten mit leberzirrhose mit hepatisher enzephalopathie, Infusionsther Klin. Ernähr. 7: 72 (1980).PubMedGoogle Scholar
  9. 9.
    F. Fiaccadori, F. Ghinelli, G. Pelosi, D. Sacchini, G. L. Vaona, M. L. Zeneroli, E. Rocchi, V. Santunione, P. Gibertini, and E. Ventura, Selective amino acid solutions in hepatic encephalopathy treatment. (A preliminary report), La Ricerca Clin. Lab. 10: 411 (1980)Google Scholar
  10. 10.
    H. J. Reiter and J. C. Bode, Parenteral application of a special amino acid solution in the treatment of severe hepatic encephalopathy, Z. Gastroenterol. 16: 457 (1978).Google Scholar
  11. 11.
    G. Dropsy and J. Boy, Determination de l’ammoniémie (méthode automatique par dialyse), An. Biol. Clin. 19: 313 (1961).Google Scholar
  12. 12.
    D. H. Spackman, W, H. Stein, and R. Moore, Automatic recording apparatus for use in the chromatography of amino acids, Anal. Chem. 30: 1190 (1958).CrossRefGoogle Scholar
  13. 13.
    G, W. Snedecor and W. G. Cochran, “Statistical Methods” sixth edition, Ames, Iowa, State University Press (1967).Google Scholar
  14. 14.
    L. Zieve, Hepatic encephalopathy: Summary of present knowledge with an elaboration on recent developments, in: “Progress in Liver Diseases,” Vol. V, Grune and Stratton, New York, pp. 327–339 (1979).Google Scholar

Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • H. Michel
    • 1
  • G. Pomier-Layrargues
    • 1
  • J. P. Aubin
    • 1
  • P. Bories
    • 1
  • D. Mirouze
    • 1
  • H. Bellet-Hermann
    • 1
  1. 1.Clinique des Maladies de l’Appareil Digestif and Laboratoire de Biochimie BHôpital Saint-EloiMontpellierFrance

Personalised recommendations