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Abstracts |

Hepatic Coma: Newer Diagnostic and Therapeutic Approaches.

Frederick Steigmann, M.D., F.A.C.P.; Vincente Yu, M.D.; and Fevzi Pamukcu, M.D.
Ann Intern Med. 1964;60(4):723-724. doi:10.7326/0003-4819-60-4-723_4
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A comatose state in a patient with a history of chronic alcoholism or chronic liver disease may be due to causes other than hepatic encephalopathy. For correct therapy it is necessary to establish whether such a patient is actually suffering from a hepatic encephalopathy or from some other conditions producing coma. Since blood ammonia levels in hepatic coma vary greatly, we have determined the glutamine level in the cerebrospinal fluid (CSF) of such patients.

We have diagnosed hepatic coma by the elevated glutamine levels (above 30 mg) in the CSF. This diagnosis was confirmed later by the clinical course, liver


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