3-Nitro-Tyrosine as a Biomarker of Minimal Hepatic Encephalopathy in Patients with Liver Cirrhosis

Abstract

epatic encephalopathy (HE) is a common complication in patient with liver cirrhosis. It comprises of a broad spectrum of neuropsychiatric abnormalities of varying severity, and affected patients usually suffer from psychomotor, cognitive, emotional, behavioural, and motor coordination dysfunctions. Patients with minimal HE (MHE), a subclinical form of HE, usually have a normal mental and neurological status upon routine clinical examination. The subtle deficits in patients with MHE can only be elicited by specialized neuropsychological tests. Despite the subclinical presentation of MHE, MHE patients are a significant burden on society and are burdened themselves, because they are more likely to suffer from car accidents, falls, a lower quality of life. Currently, the “ gold standard ” for diagnosis of MHE is the psychometric hepatic encephalopathy score (PHES), a battery of four psychometric tests. However, PHES is time consuming and needs adjusting for age and educational level. As aconsequence, MHE is not routinely diagnosed in most clinical settings because of lack of simple procedures, and most patients with MHE remain undiagnosed and untreated. It would