Blood Ammonia Level Correlates with Severity of Cirrhotic Portal Hypertensive Gastropathy
Joint Authors
Kobtan, Abdelrahman
Abd-Elsalam, Sherief
El-Kalla, Ferial
Mansour, Loai
Elhendawy, Mohamed
Elzeftawy, Asmaa
Abo Ali, Lobna
Elyamani, Sahar
Yousef, Mohamed
Amer, I.
Mourad, H.
Source
Gastroenterology Research and Practice
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-07-29
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Background.
Portal hypertensive gastropathy (PHG) is a common anomaly with potential for bleeding found in portal hypertension.
Blood ammonia levels correlate well with liver disease severity and existence of portosystemic shunts.
Increased ammonia results in vasodilation and hepatic stellate cell activation causing and exacerbating portal hypertension.
Objective.
To assess the relation of blood ammonia to the presence and severity of portal hypertensive gastropathy in cirrhosis.
Methods.
This cross-sectional study included 381 cirrhotics undergoing screening for esophageal varices (EV) divided into a portal hypertensive gastropathy group (203 patients with EV and PHG), esophageal varix group (41 patients with EV but no PHG), and control group (137 patients with no EV or PHG).
A full clinical examination, routine laboratory tests, abdominal ultrasonography, child score calculation, and blood ammonia measurement were performed for all patients.
Results.
Blood ammonia, portal vein, splenic vein, and splenic longitudinal diameters were significantly higher and platelet counts lower in patients with EV and EV with PHG than controls.
Patients having EV with PHG had significantly higher bilirubin and ammonia than those with EV but no PHG.
Severe PHG was associated with significantly higher ammonia, EV grades, and superior location and a lower splenic longitudinal diameter than mild PHG.
The PHG score showed a positive correlation with blood ammonia and a negative correlation with splenic longitudinal diameter.
Conclusions.
Blood ammonia levels correlate with the presence, severity, and score of portal hypertensive gastropathy in cirrhosis suggesting a causal relationship and encouraging trials of ammonia-lowering treatments for the management of severe PHG with a tendency to bleed.
American Psychological Association (APA)
El-Kalla, Ferial& Mansour, Loai& Kobtan, Abdelrahman& Elzeftawy, Asmaa& Abo Ali, Lobna& Abd-Elsalam, Sherief…[et al.]. 2018. Blood Ammonia Level Correlates with Severity of Cirrhotic Portal Hypertensive Gastropathy. Gastroenterology Research and Practice،Vol. 2018, no. 2018, pp.1-9.
https://search.emarefa.net/detail/BIM-1165904
Modern Language Association (MLA)
El-Kalla, Ferial…[et al.]. Blood Ammonia Level Correlates with Severity of Cirrhotic Portal Hypertensive Gastropathy. Gastroenterology Research and Practice No. 2018 (2018), pp.1-9.
https://search.emarefa.net/detail/BIM-1165904
American Medical Association (AMA)
El-Kalla, Ferial& Mansour, Loai& Kobtan, Abdelrahman& Elzeftawy, Asmaa& Abo Ali, Lobna& Abd-Elsalam, Sherief…[et al.]. Blood Ammonia Level Correlates with Severity of Cirrhotic Portal Hypertensive Gastropathy. Gastroenterology Research and Practice. 2018. Vol. 2018, no. 2018, pp.1-9.
https://search.emarefa.net/detail/BIM-1165904
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1165904