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Normal protein diet and L-ornithine-L-aspartate for hepatic encephalopathy.
Acta Med Indones. 2010 Jul; 42(3):158-61.AM

Abstract

Excessive protein intake can cause hepatic encephalopathy (HE). Restricting protein in HE is becoming a controversy, because it can worsen malnutrition. This article reports the case of an under nourishment HE which is treated with L-ornithine-L-aspartate (LOLA) and given appropriate diet according to the nutrition status. A 62-year-old man came with chief complaint of having reduced consciousness since 6 hours before admission. He had been diagnosed as liver cirrhosis for 6 years. Several days prior to admission he took high protein diet. Physical examination revealed under nutrition and unconsciousness. Hepatic encephalopathy was confirmed with low critical flicker test (CFF), and high blood ammonia level. He was treated with adequate diet and LOLA to decrease blood ammonia and improve the CFF. During the treatment, consciousness improved to normal, CFF increased and ammonia level decreased. In this case, the HE was treated with LOLA without protein restriction. The HE improvement, in this circumstance may be caused of LOLA treatment that helps decrease the plasma ammonia level. Adequate diet, 35-40 kcal/kgBW/d and protein intake 1.5 g/kgBW/d, has been administered safely to this patient with stage II hepatic encephalopathy. LOLA seemed to be effectively reduced ammonia level and improved the encephalopathy.

Authors+Show Affiliations

Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Dr. Cipto Mangunkusumo Hospital, Jl. Diponegoro no. 71, Jakarta Pusat 10430, Indonesia. susan_ndraha@yahoo.co.idNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20724770

Citation

Ndraha, Suzanna, and Marcellus Simadibrata. "Normal Protein Diet and L-ornithine-L-aspartate for Hepatic Encephalopathy." Acta Medica Indonesiana, vol. 42, no. 3, 2010, pp. 158-61.
Ndraha S, Simadibrata M. Normal protein diet and L-ornithine-L-aspartate for hepatic encephalopathy. Acta Med Indones. 2010;42(3):158-61.
Ndraha, S., & Simadibrata, M. (2010). Normal protein diet and L-ornithine-L-aspartate for hepatic encephalopathy. Acta Medica Indonesiana, 42(3), 158-61.
Ndraha S, Simadibrata M. Normal Protein Diet and L-ornithine-L-aspartate for Hepatic Encephalopathy. Acta Med Indones. 2010;42(3):158-61. PubMed PMID: 20724770.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Normal protein diet and L-ornithine-L-aspartate for hepatic encephalopathy. AU - Ndraha,Suzanna, AU - Simadibrata,Marcellus, PY - 2010/8/21/entrez PY - 2010/8/21/pubmed PY - 2011/4/6/medline SP - 158 EP - 61 JF - Acta medica Indonesiana JO - Acta Med Indones VL - 42 IS - 3 N2 - Excessive protein intake can cause hepatic encephalopathy (HE). Restricting protein in HE is becoming a controversy, because it can worsen malnutrition. This article reports the case of an under nourishment HE which is treated with L-ornithine-L-aspartate (LOLA) and given appropriate diet according to the nutrition status. A 62-year-old man came with chief complaint of having reduced consciousness since 6 hours before admission. He had been diagnosed as liver cirrhosis for 6 years. Several days prior to admission he took high protein diet. Physical examination revealed under nutrition and unconsciousness. Hepatic encephalopathy was confirmed with low critical flicker test (CFF), and high blood ammonia level. He was treated with adequate diet and LOLA to decrease blood ammonia and improve the CFF. During the treatment, consciousness improved to normal, CFF increased and ammonia level decreased. In this case, the HE was treated with LOLA without protein restriction. The HE improvement, in this circumstance may be caused of LOLA treatment that helps decrease the plasma ammonia level. Adequate diet, 35-40 kcal/kgBW/d and protein intake 1.5 g/kgBW/d, has been administered safely to this patient with stage II hepatic encephalopathy. LOLA seemed to be effectively reduced ammonia level and improved the encephalopathy. SN - 0125-9326 UR - https://www.unboundmedicine.com/medline/citation/20724770/Normal_protein_diet_and_L_ornithine_L_aspartate_for_hepatic_encephalopathy_ L2 - http://www.inaactamedica.org/archives/2010/20724770.pdf DB - PRIME DP - Unbound Medicine ER -