Hepatic Encephalopathy

Arthur J.l. Cooper; Fred Plum; Alan H. Lockwood; David W. Mccandless; Peter G. Traber; Milton M. Lieberthal; Parker Vanamee; Saul W. Brusilow; Richard Traystman; Cosmo L. Fraser; Allen I. Arieff

doi:10.1056/NEJM198603203141215

Hepatic Encephalopathy

Arthur J.l. Cooper
, Fred Plum
, Alan H. Lockwood
, David W. Mccandless
, Peter G. Traber
, Milton M. Lieberthal
, Parker Vanamee
, Saul W. Brusilow
, Richard Traystman
, Cosmo L. Fraser
, Allen I. Arieff

Neurology

Cornell University
University of Texas Health Science Center at Houston
Northwestern University
University of Cincinnati
Memorial Sloan-Kettering Cancer Center
Johns Hopkins University
University of California at San Francisco

Research output: Contribution to journal › Letter › peer-review

6 Scopus citations

Abstract

To the Editor: The Medical Progress article on hepatic encephalopathy by Fraser and Arieff (Oct. 3 issue)¹ contains several errors that could lead to mistakes of understanding or treatment. It states, “After ammonia is generated [in the gut], it is transported through the portal circulation to the liver, where it is normally converted to urea.” However, 30 to 40 percent of ammonia is also converted to glutamine in the liver.² The authors imply that an increased cerebral catabolism of amino acids results in elevated ammonia concentrations in the hyperammonemic brain. The five cited references are inappropriate. The best evidence suggests…

Original language	English
Pages (from-to)	784-787
Number of pages	4
Journal	New England Journal of Medicine
Volume	314
Issue number	12
DOIs	https://doi.org/10.1056/NEJM198603203141215
State	Published - Mar 20 1986

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title = "Hepatic Encephalopathy",

abstract = "To the Editor: The Medical Progress article on hepatic encephalopathy by Fraser and Arieff (Oct. 3 issue)1 contains several errors that could lead to mistakes of understanding or treatment. It states, “After ammonia is generated [in the gut], it is transported through the portal circulation to the liver, where it is normally converted to urea.” However, 30 to 40 percent of ammonia is also converted to glutamine in the liver.2 The authors imply that an increased cerebral catabolism of amino acids results in elevated ammonia concentrations in the hyperammonemic brain. The five cited references are inappropriate. The best evidence suggests…",

author = "Cooper, \{Arthur J.l.\} and Fred Plum and Lockwood, \{Alan H.\} and Mccandless, \{David W.\} and Traber, \{Peter G.\} and Lieberthal, \{Milton M.\} and Parker Vanamee and Brusilow, \{Saul W.\} and Richard Traystman and Fraser, \{Cosmo L.\} and Arieff, \{Allen I.\}",

year = "1986",

month = mar,

day = "20",

doi = "10.1056/NEJM198603203141215",

language = "English",

volume = "314",

pages = "784--787",

journal = "New England Journal of Medicine",

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}

TY - JOUR

T1 - Hepatic Encephalopathy

AU - Cooper, Arthur J.l.

AU - Plum, Fred

AU - Lockwood, Alan H.

AU - Mccandless, David W.

AU - Traber, Peter G.

AU - Lieberthal, Milton M.

AU - Vanamee, Parker

AU - Brusilow, Saul W.

AU - Traystman, Richard

AU - Fraser, Cosmo L.

AU - Arieff, Allen I.

PY - 1986/3/20

Y1 - 1986/3/20

N2 - To the Editor: The Medical Progress article on hepatic encephalopathy by Fraser and Arieff (Oct. 3 issue)1 contains several errors that could lead to mistakes of understanding or treatment. It states, “After ammonia is generated [in the gut], it is transported through the portal circulation to the liver, where it is normally converted to urea.” However, 30 to 40 percent of ammonia is also converted to glutamine in the liver.2 The authors imply that an increased cerebral catabolism of amino acids results in elevated ammonia concentrations in the hyperammonemic brain. The five cited references are inappropriate. The best evidence suggests…

AB - To the Editor: The Medical Progress article on hepatic encephalopathy by Fraser and Arieff (Oct. 3 issue)1 contains several errors that could lead to mistakes of understanding or treatment. It states, “After ammonia is generated [in the gut], it is transported through the portal circulation to the liver, where it is normally converted to urea.” However, 30 to 40 percent of ammonia is also converted to glutamine in the liver.2 The authors imply that an increased cerebral catabolism of amino acids results in elevated ammonia concentrations in the hyperammonemic brain. The five cited references are inappropriate. The best evidence suggests…

UR - https://www.scopus.com/pages/publications/0022650044

U2 - 10.1056/NEJM198603203141215

DO - 10.1056/NEJM198603203141215

M3 - Letter

C2 - 3951510

AN - SCOPUS:0022650044

SN - 0028-4793

VL - 314

SP - 784

EP - 787

JO - New England Journal of Medicine

JF - New England Journal of Medicine

IS - 12

ER -

Hepatic Encephalopathy

Abstract

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