The Role of Interleukin 6 (IL6) and Ammonia in Lactulose Non-Responders Minimal Hepatic Encephalopathy Patients

Abstract

Hepatic encephalopathy (HE) may be defined as a disturbance of the central nervous system (CNS) function secondary to porto –systemic shunting . It represents a wide spectrum of neuropsychiatric abnormalities seen in patients with liver dysfunction after exclusion of other known neurological diseases. In some cases, hepatic encephalopathy presents with overt seizure activity. When neurological deficits are subtle but the neurological clinical examination is normal, a condition referred to as minimal HE. Lactulose is commonly used in the treatment of hepatic encephalopathy (HE). However not all patients respond to lactulose After correction of any associated precipitating factors, Non response was defined if patient remained in HE even after 10 days of treatment or died while in HE. Low serum sodium and a high venous ammonia level were significantly associated with a low response to lactulose.