What are common precipitants of hyperammonemia and worsening mental status in hepatic encephalopathy?

Updated: Jul 30, 2018
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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Answer

Answer

Some patients with a history of hepatic encephalopathy have normal mental status when under medical therapy. Others have chronic memory impairment in spite of medical management. Both groups of patients are subject to episodes of worsened encephalopathy. Common precipitants of hyperammonemia and worsening mental status are as follows:

  • Diuretic therapy

  • Hypovolemia

  • Renal failure

  • GI bleeding

  • Infection

  • Constipation


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