Abstract
Venous blood ammonium levels were studied in 106 control subjects and 47 patients with varying degrees of liver disorder. The resting venous blood ammonium was normally distributed in both male and female control subjects and was not influenced by either the sex or the fasting state of the subject. In general it was also uninfluenced by age except that the level was found to be a little lower in subjects over 60 years of age probably due to their state of greater muscular inactivity.
The mean resting ammonium level in controls was 80·0 μg/100 ml ± 17·17 μg/100 ml and the range (mean ± 2 SD) 46-114 μg/100 ml. Raised levels were obtained in 16·7% of patients with subclinical liver disorder, 62·5% with moderate liver disorder, and 85·5% with severe liver disorder, indicating a relationship between the severity of liver disorder and the resting venous blood ammonium level. As the majority of patients with severe liver disorder were known to have varices the raised ammonium levels are likely to have been related to the greater magnitude and incidence of portal systemic shunts in those with severe liver disease.
Full text
PDF






Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- ALLEN S. I., CONN H. O. Observations on the effect of exercise on blood ammonia concentration in man. Yale J Biol Med. 1960 Oct;33:133–144. [PMC free article] [PubMed] [Google Scholar]
- BESSMAN A. N., EVANS J. M. The blood ammonia in congestive heart failure. Am Heart J. 1955 Nov;50(5):715–719. doi: 10.1016/0002-8703(55)90178-2. [DOI] [PubMed] [Google Scholar]
- BROMBERG P. A., ROBIN E. D., FORKNER C. E., Jr The existence of ammonia in blood in vivo with observations on the significance of the NH4 plus minus NH3 system. J Clin Invest. 1960 Feb;39:332–341. doi: 10.1172/JCI104044. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Conway E. J. Apparatus for the micro-determination of certain volatile substances: The blood ammonia, with observations on normal human blood. Biochem J. 1935 Dec;29(12):2755–2772. doi: 10.1042/bj0292755. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DUTTON R., Jr, NICHOLAS W., FISHER C. J., RENZETTI A. D., Jr Blood ammonia in chronic pulmonary emphysema. N Engl J Med. 1959 Dec 31;261:1369–1373. doi: 10.1056/NEJM195912312612704. [DOI] [PubMed] [Google Scholar]
- EGENSE J. Ammonium tolerance test. A diagnostic aid in liver diseases. Acta Med Scand. 1960 May 20;167:53–59. doi: 10.1111/j.0954-6820.1960.tb03515.x. [DOI] [PubMed] [Google Scholar]
- MCDERMOTT W. V., Jr, WAREHAM J., RIDDELL A. G. Treatment of hepatic coma with L-glutamic acid. N Engl J Med. 1955 Dec 22;253(25):1093–1102. doi: 10.1056/NEJM195512222532501. [DOI] [PubMed] [Google Scholar]
- McCullough H. The determination of ammonia in whole blood by a direct colorimetric method. Clin Chim Acta. 1967 Aug;17(2):297–304. doi: 10.1016/0009-8981(67)90133-7. [DOI] [PubMed] [Google Scholar]
- McDERMOTT W. V., Jr, ADAMS R. D. Episodic stupor associated with an Eck fistula in the human with particular reference to the metabolism of ammonia. J Clin Invest. 1954 Jan;33(1):1–9. doi: 10.1172/JCI102862. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mondzac A., Ehrlich G. E., Seegmiller J. E. An enzymatic determination of ammonia in biological fluids. J Lab Clin Med. 1965 Sep;66(3):526–531. [PubMed] [Google Scholar]
- NIELSEN O. F., LIANG Y. K., CHEY W. Y. EFFECT OF PROTEIN ADMINISTRATION ON AMMONIA LEVELS OF PATIENTS WITH LIVER DISEASE. Am J Med Sci. 1965 Aug;250:121–130. [PubMed] [Google Scholar]
- Okuda H., Fujii S., Kawashima Y. A direct colorimetric determination of blood ammonia. Tokushima J Exp Med. 1965 May;12(1):11–23. [PubMed] [Google Scholar]
- PEREA V. D., NELSON R. S. BLOOD AMMONIA LEVELS IN PRIMARY AND METASTATIC CANCER OF THE LIVER. Clin Chim Acta. 1964 Jan;9:13–18. doi: 10.1016/0009-8981(64)90039-7. [DOI] [PubMed] [Google Scholar]
- PHEAR E. A., SHERLOCK S., SUMMERSKILL W. H. Blood-ammonium levels in liver disease and hepatic coma. Lancet. 1955 Apr 23;268(6869):836–840. doi: 10.1016/s0140-6736(55)90422-0. [DOI] [PubMed] [Google Scholar]
- SELIGSON D., HIRAHARA K. The measurement of ammonia in whole blood, erythrocytes, and plasma. J Lab Clin Med. 1957 Jun;49(6):962–974. [PubMed] [Google Scholar]
- STAHL J. Studies of the blood ammonia in liver disease. Its diagnostic, prognostic, and therapeutic significance. Ann Intern Med. 1963 Jan;58:1–24. doi: 10.7326/0003-4819-58-1-1. [DOI] [PubMed] [Google Scholar]
- Zieve L. Pathogenesis of hepatic coma. Arch Intern Med. 1966 Sep;118(3):211–223. [PubMed] [Google Scholar]
- v d. BURG P., MOOK H. W. A simple and rapid method for the determination of ammonia in blood. Clin Chim Acta. 1963 Jan;8:162–164. doi: 10.1016/0009-8981(63)90219-5. [DOI] [PubMed] [Google Scholar]
