The clinical significance of hyperammonemia in the Chernobyl accident liquidators with nonalcoholic steatohepatitis at the precirrotic stage

Relevance. It is known that diffuse liver diseases can be associated with increased ammonia levels in blood serum, that have toxic effects on the central nervous system. Intention. To establish the clinical importance of hyperammonemia in chronic non-alcoholic steatohepatitis in the liquidators of Chernobyl nuclear power (CNPP) plant accident aftermath. Methods. In 65 Chernobyl accident liquidators, liver fibrosis, plasma ammonia levels were also assessed via enzyme method in addition to general clinical examination, including microbiota disorders. Results and Discussion. Hyperammonemia was detected in 46 % of liquidators with chronic nonalcoholic steatohepatitis, with greater severity of clinical manifestations of asthenic-vegetative and dyspeptic syndromes, liver fibrosis and disorders of intestinal microbiota and intrahepatic hemodynamics, including noncyrrotic portal hypertension. In previous studies, the role of hyperammonemia was mainly studied at the stage of the formed cirrhosis of the liver accompanied by the hepatic encephalopathy. Conclusion. It is necessary to determine the level of ammonia in the blood plasma in all liquidators of CNPP accident aftermath suffering from chronic non-alcoholic steatohepatitis.

radiation accident, Chernobyl nuclear power plant, liquidator of the accident aftermath, non-alcoholic steatohepatitis, hyperammonemia, noncyrrotic portal hypertension

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