Abstract
In a prospective study of 47 patients of subclinical hepatic encephalopathy in cirrhosis of liver, aged between 23 and 60 years, 49% showed Helicobacter pylori positivity by rapid urease test. The baseline characters of patients (mean age, serum creatinine, sereum albumin, serum bilirubin, prothrombin time) were similar among patients with and without Helicobacter infection in all the patients. There was no statistically significant difference in blood ammonia levels in either group of patients. Blood ammonia values showed good correlation with the functional state of liver function but they did not show statistically significant difference between two groups of patients in any of Child Pugh classes. It is concluded that Helicobacter pylori does not contribute significantly to blood ammonia levels and the severity of hepatic encephalopathy.
Key words: Helicobacter pylori, Hyperammonemia, Cirrhosis of liver, Hepatic encephalopathy
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References
- 1.Schenker S, Hoyumpa AM. Pathophysiology of hepatic encephalopathy. Hosp Prac. 1984;19:99–103. doi: 10.1080/21548331.1984.11702908. [DOI] [PubMed] [Google Scholar]
- 2.Zieve L. Pathogenesis of hepatic encephalopathy. Metab Brain diseases. 1987;2:147–65. doi: 10.1007/BF00999607. [DOI] [PubMed] [Google Scholar]
- 3.Dunn BE, Campbell GP, Perez-Perez GI, Blaser MJ. Purification and characterization of urease from Helecobacter pylori. J Biol Chem. 1990;265:9464–9. [PubMed] [Google Scholar]
- 4.Ito S, Miyaji H, Azuma T, Li Y, Ito Y, Kato T, et al. Hyperammonemia and Helecobacter pylori. Lancet. 1995;346(8967):124–5. doi: 10.1016/S0140-6736(95)92147-8. [DOI] [PubMed] [Google Scholar]
- 5.Plevris JN, Morgenstern R, Hayes PC, Bouchier IA. Hyperammonia in cirrhosis and Helecobacter pylori infection. Lancet. 1995;346(8982):1104–1104. doi: 10.1016/S0140-6736(95)91780-2. [DOI] [PubMed] [Google Scholar]
- 6.Rinaldi V, Zullo A, Diana F, Capocaccia L. Helecobacter pylori, hyperammonemia and hepatic encephalopathy; is there a correlation? Am J Gastroenterology. 1997;82:723–4. [PubMed] [Google Scholar]
- 7.Miyaji H, Azuma T, Ito Y, Yamazaki Y, Ohtaki Y, Sato F, et al. Effects of H. pylori eradication therapy on hyperammonia in patients with liver cirrhosis. Gut. 1997;40:726–30. doi: 10.1136/gut.40.6.726. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Jalan R, Seery J, Taylor-Robinson SD. Pathogenesis and treatment of hepaticencephalopathy. Aliment Pharmac Ther. 1996;10:681–7. doi: 10.1046/j.1365-2036.1996.58200000.x. [DOI] [PubMed] [Google Scholar]
- 9.Affli AF, Rinaldi V, et al. H. pylori- a major determinant of serum ammonia levels in cirrhotic patients. J Hepatol. 1994;20:110A–110A. [Google Scholar]
- 10.Rossala M, Haag K, et al. H. pylori is not associated with increased risk of hepatic encephalopathy. J Hepatol. 1994;20:111A–111A. doi: 10.1002/hep.1840200118. [DOI] [Google Scholar]
- 11.Vasconez C, Elizalde JI, Llach J, Gines A, Rosa C, Fernendez RM, et al. H. pylori, hyperammonia and subclinical portal-systemic encephalopathy: effects of eradication. J Hepatol. 1999;30:260–64. doi: 10.1016/S0168-8278(99)80072-5. [DOI] [PubMed] [Google Scholar]
- 12.Kini D, Agarwal R, Va Saraswat, Naik SR. Role of Helecobacter pylori in hyperammonia and subclinical hepatic encephalopathy in cirrhosis of liver. Indian J Gastroenterol. 2001;20:237–40. [PubMed] [Google Scholar]
- 13.Laine L, Lewin D, Naritoku W, Estrada R, Cohen H. Prospective comparison of commercially available rapid urease tests for the diagnosis of Helecobacter pylori. Gastrointestin Endosc. 1996;44:523–6. doi: 10.1016/S0016-5107(96)70002-0. [DOI] [PubMed] [Google Scholar]
- 14.Si J, Cao Q, Gao M, Fang L, Qian G, Wang Y. Changes in serum ammonia concentration in cirrhotic patients with Helecobacter pylori infection. Chin Med J. 2000;113:1080–81. [PubMed] [Google Scholar]
- 15.Dasani BM, Sigal SH, Lieber CS. Analysis of risk factors for chronic hepaticencephalopathy: the role of H. pylori infection. Am J Gastroenterology. 1998;93:726–31. doi: 10.1111/j.1572-0241.1998.214_a.x. [DOI] [PubMed] [Google Scholar]