11541

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

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Last updated: 03 Jan 2025

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Abstract

Background: hepatic 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. Aim of the Work: the aim of this study was to evaluate the role of 3-Nitro-Tyrosine as a biomarker of Minimal Hepatic Encephalopathy in patients with liver cirrhosis. Patients and Methods: our conducted study was a prospective case control study carried on 60 adult patients and 30 age matched controls. All were recruited from Internal Medicine and Hepatology and Gastroenterology Department at Ain Shams University Hospitals in the period between September 2016 and June 2018. All patients enrolled in the study were subjected to detailed history taking, full physical examination, laboratory investigations, psychometric tests for detection of MHE using specially digit symbol test (DST), Trail making test A (TMT A), Trail making test B (TMT B), serial dotting test (SDT) and 3-Nitro-Tyrosine level (3NT). Results: our study found that the serum levels of 3-nitro-tyrosine are a good predictor of the presence of MHE in patients with liver cirrhosis, with good sensitivity (90%) and specificity (93.33%) and positive and negative predictive values were 93.1% and 90.3% respectively at a cutoff of 14.8 ng. Conclusion: determination of 3-nitro-tyrosine in serum is easy and is not time consuming. It only requires taking a serum sample from the patient and determining 3-nitro-tyrosine concentration. This procedure can be therefore easily added to the routine clinical determinations in patients with liver cirrhosis. This would also allow extending the diagnosis of MHE to most clinical settings, helping to identify patients with MHE.

DOI

10.21608/ejhm.2018.11541

Keywords

3-Nitro-Tyrosine, hepatic encephalopathy, Liver cirrhosis

Authors

First Name

Emad Ahmed

Last Name

Awad

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Affiliation

Department of Internal Medicine and Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University

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Orcid

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First Name

Mansour Nassef

Last Name

Mohammed

MiddleName

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Affiliation

Department of Internal Medicine and Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University

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Orcid

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First Name

Moataz Mohammed

Last Name

Sayyed

MiddleName

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Affiliation

Department of Internal Medicine and Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University

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Orcid

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First Name

Ahmed El-Saady

Last Name

El-Khayal

MiddleName

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Affiliation

Department of Internal Medicine and Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University

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City

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Orcid

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First Name

Mohamed Ahmed Saad

Last Name

Ahmed

MiddleName

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Affiliation

Department of Internal Medicine and Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University

Email

just_human_86@hotmail.com

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Orcid

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Volume

72

Article Issue

11

Related Issue

2148

Issue Date

2018-07-01

Receive Date

2018-08-26

Publish Date

2018-07-01

Page Start

5,647

Page End

5,651

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_11541.html

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https://ejhm.journals.ekb.eg/service?article_code=11541

Order

22

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

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

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Article

Created At

22 Jan 2023