The hepatic component in alcoholic encephalopathy

In a group of 34 chronic alcohol addicts with neuropsychic manifestations--alcoholic encephalopathy (AE)--and 9 subjects with chronic non-alcoholic liver diseases, biochemical (ammonemia, pyruvicemia, lactacidemia), enzymatic (gamma-glutamyltranspeptidase (gamma-GPT)) and morphological assays were carried out comparatively with conventional liver investigations. Alcoholic liver disease was found present in 16 patients (47%). A peculiar biochemical profile was observed in subjects with hepato-alcoholic encephalopathy: ammonemia 191.3 +/- 70.3 gamma %, pyruvicemia 2.7 +/- 0.82 mg %, lactacidemia 15.76 mg % and gamma-GPT 80.5 U/l, as compared with ammonemia 121 +/- 33.5 gamma %, pyruvicemia 2.74 +/- 1.2 mg %, lactacidemia 16.65 mg % and gamma-GPT 42.6 U/l in AE without hepatic disease, and in non-alcoholic liver diseases in which ammonemia was 88.6 gamma % (in chronic hepatitis) and 126.3 gamma % (in hepatic cirrhosis). Thus, coexisting involvement of the liver and presence of portal-systemic shunts in AE can be estimated by the assay of certain biochemical and enzymatic parameters.