Which laboratory finding is typically elevated in hepatic encephalopathy?

Which laboratory finding is typically elevated in hepatic encephalopathy?

• A. Ammonia
• B. ALT
• C. AST
• D. Albumin

Answer: (A)

Hepatic encephalopathy stems from the liver’s inability to detoxify ammonia produced by gut bacteria. Normally, ammonia is converted to urea in the liver and excreted by the kidneys. When liver function is impaired or portosystemic shunting bypasses the liver, ammonia accumulates in the blood and crosses into the brain, where it disrupts neurotransmission and causes cognitive changes, confusion, sleep disturbances, and asterixis. That makes ammonia the lab finding most characteristically elevated in hepatic encephalopathy. ALT and AST indicate hepatocellular injury, and albumin reflects long-term liver synthetic function; neither specifically signals encephalopathy.

Hepatic encephalopathy stems from the liver’s inability to detoxify ammonia produced by gut bacteria. Normally, ammonia is converted to urea in the liver and excreted by the kidneys. When liver function is impaired or portosystemic shunting bypasses the liver, ammonia accumulates in the blood and crosses into the brain, where it disrupts neurotransmission and causes cognitive changes, confusion, sleep disturbances, and asterixis. That makes ammonia the lab finding most characteristically elevated in hepatic encephalopathy.

ALT and AST indicate hepatocellular injury, and albumin reflects long-term liver synthetic function; neither specifically signals encephalopathy.