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As recently published by Dukic and Simundic1 in this journal, measurement of reliable ammonia is a real challenge in clinical chemistry. This was brought to the point by Burtis et al (1994) in Tietz Textbook of Clinical Chemistry using the following statement: ‘The key to reliable values from ammonia assays is control of sources of preanalytical error’.2
In this context, the authors discuss that correct ammonia values depend—beside other critical preanalytical conditions—on the activity of γ-glutamyl-transferase (GGT) by hydrolysing glutamine.3
This might be a problem in patients with advanced liver disease due …
Contributors The conception of the work, acquisition of the material, analysis and interpretation of data were completed by PS-W and MS.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.