Background: In cirrhotic liver increased secretion of endotoxin by extrahepatic macrophages
may play an important role in the progression of Hepatic encephalopathy (HE). The aim of the present
study was to evaluate serum endotoxin in cirrhotic patients with HE and to investigate relation between
serum endotoxin level and severity of liver disease and grades of HE. Patient and methods : This study
included Four groups: Group I was 25 apparent healthy age and sex matched participants as a control
group. Group II was 25 cirrhotic patients without HE. Group III was 25 cirrhotic patients with minimal
HE and Group IV was 25 patients with overt HE. Serum endotoxin was measured in the 4
groups..Results: there was a high statistically significant positive correlation between endotoxin level
with WBCs, PT, INR, PTT, RBS, ALT, AST, total, direct bilirubin, urea, creatinine, and HE grades,
while there was statistically significant negative correlation with Hb, platelets, serum K, Na level. Total
proteins, serum albumin, child pugh score and GCS. Endotoxin level can detect 100% of HE patients
and excluding 97.3% of cirrhotic patients with no encephalopathy, with 98% accuracy. Conclusion:
Serum endotoxins is elevated in patients with HE. Serum endotoxin correlate well with grades of HE.