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The hepatic component in alcoholic encephalopathy

T Banciu, H Weidenfeld, V Wilham

    Medecine Interne
    |January 1, 1982
    PubMed
    Summary

    Chronic alcohol addicts with alcoholic encephalopathy (AE) and liver disease show distinct biochemical markers. These indicators, including ammonemia and gamma-glutamyltranspeptidase (gamma-GPT), help estimate liver involvement and portal-systemic shunts in AE.

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    Area of Science:

    • Hepatology
    • Neurology
    • Clinical Biochemistry

    Background:

    • Chronic alcohol abuse frequently leads to neuropsychic disorders like alcoholic encephalopathy (AE).
    • Liver damage, including alcoholic liver disease, is a common complication in chronic alcoholics.
    • Distinguishing AE with concurrent liver disease from AE without hepatic involvement is clinically significant.

    Purpose of the Study:

    • To investigate and compare biochemical and enzymatic profiles in chronic alcohol addicts with AE, differentiating those with and without coexisting liver disease.
    • To assess the utility of specific biochemical markers in identifying liver involvement and portal-systemic shunts in AE patients.

    Main Methods:

    • Biochemical assays (ammonemia, pyruvicemia, lactacidemia) and enzymatic assays (gamma-glutamyltranspeptidase (gamma-GPT)) were performed.

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  • Morphological assays and conventional liver investigations were also conducted.
  • Comparative analysis was performed between groups: AE with liver disease, AE without liver disease, and non-alcoholic liver diseases.

    • Main Results:

    • Alcoholic liver disease was identified in 47% of the chronic alcohol addicts.
    • Hepato-alcoholic encephalopathy patients exhibited a distinct biochemical profile: elevated ammonemia (191.3 +/- 70.3 gamma %), elevated pyruvicemia (2.7 +/- 0.82 mg %), and higher gamma-GPT (80.5 U/l).
    • These levels differed significantly from AE without hepatic disease and non-alcoholic liver diseases (chronic hepatitis, hepatic cirrhosis).

    Conclusions:

    • Specific biochemical and enzymatic parameters, including ammonemia and gamma-GPT, can help estimate the presence of coexisting liver disease in patients with alcoholic encephalopathy.
    • The findings suggest that these assays can aid in detecting portal-systemic shunts associated with liver involvement in AE.
    • This biochemical profiling offers a valuable non-invasive method for assessing the complex interplay between liver function and neurological manifestations in chronic alcoholism.