Amino acids in liver disease: A cause of hepatic encephalopathy?
1979
Baker, Alfred L.
Patients with chronic liver disease often have elevations in plasma levels of aromatic amino acids while branch-chain amino acids are depressed. This may have etiologic importance in hepatic coma. The restoration of this ratio to normal should provide treatment for hepatic encephalopathy and should attain a nitrogen balance without precipitating hepatic coma. Nutritional depletion has been linked to histological lesions even in the absence of alcohol abuse. Although one patient with postnecrotic cirrhosis and chronic hepatic encephalopathy responded to oral amino acid solution along with 20 g protein diet, indicating false neurotransmitters as a cause of hepatic encephalopathy, other studies do not show this relationship. Careful dietary trials should be undertaken in patients with chronic liver disease, varying amino acid content and other constituents, to clarify response to treatment and to formulate precise dietary treatment.
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