Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature

Purpose. A 66-year-old man who presented with coma was found to have isolated severe hyperammonemia and diagnosed with a late-onset urea-cycle disorder. He was treated successfully and had full recovery. Methods. We report a novel case of noncirrhotic hyperammonemia and review the literature on this...

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Main Authors: Ruby Upadhyay, Thomas P. Bleck, Katharina M. Busl
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2016/8512721
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author Ruby Upadhyay
Thomas P. Bleck
Katharina M. Busl
author_facet Ruby Upadhyay
Thomas P. Bleck
Katharina M. Busl
author_sort Ruby Upadhyay
collection DOAJ
description Purpose. A 66-year-old man who presented with coma was found to have isolated severe hyperammonemia and diagnosed with a late-onset urea-cycle disorder. He was treated successfully and had full recovery. Methods. We report a novel case of noncirrhotic hyperammonemia and review the literature on this topic. Selected literature for review included English-language articles concerning hyperammonemia using the search terms “hyperammonemic encephalopathy”, “non-cirrhotic encephalopathy”, “hepatic encephalopathy”, “urea-cycle disorders”, “ornithine transcarbamylase (OTC) deficiency”, and “fulminant hepatic failure”. Results. A unique case of isolated hyperammonemia diagnosed as late-onset OTC deficiency is presented. Existing evidence about hyperammonemia is organized to address pathophysiology, clinical presentation, diagnosis, and treatment. The case report is discussed in context of the reviewed literature. Conclusion. Late-onset OTC deficiency presenting with severe hyperammonemic encephalopathy and extensive imaging correlate can be fully reversible if recognized promptly and treated aggressively.
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spelling doaj-art-cba205e1915f4eebbfd267a3eed64a392025-02-03T06:06:59ZengWileyCase Reports in Medicine1687-96271687-96352016-01-01201610.1155/2016/85127218512721Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the LiteratureRuby Upadhyay0Thomas P. Bleck1Katharina M. Busl2Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street, POB Suite 1121, Chicago, IL 60612, USARush Medical College, Rush University Medical Center, 600 S. Paulina Street, Chicago, IL 60612, USADepartment of Neurology, Division of Neurocritical Care, University of Florida, McKnight Brain Institute, Room L3-100, 1149 Newell Drive, Gainesville, FL 32611, USAPurpose. A 66-year-old man who presented with coma was found to have isolated severe hyperammonemia and diagnosed with a late-onset urea-cycle disorder. He was treated successfully and had full recovery. Methods. We report a novel case of noncirrhotic hyperammonemia and review the literature on this topic. Selected literature for review included English-language articles concerning hyperammonemia using the search terms “hyperammonemic encephalopathy”, “non-cirrhotic encephalopathy”, “hepatic encephalopathy”, “urea-cycle disorders”, “ornithine transcarbamylase (OTC) deficiency”, and “fulminant hepatic failure”. Results. A unique case of isolated hyperammonemia diagnosed as late-onset OTC deficiency is presented. Existing evidence about hyperammonemia is organized to address pathophysiology, clinical presentation, diagnosis, and treatment. The case report is discussed in context of the reviewed literature. Conclusion. Late-onset OTC deficiency presenting with severe hyperammonemic encephalopathy and extensive imaging correlate can be fully reversible if recognized promptly and treated aggressively.http://dx.doi.org/10.1155/2016/8512721
spellingShingle Ruby Upadhyay
Thomas P. Bleck
Katharina M. Busl
Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature
Case Reports in Medicine
title Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature
title_full Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature
title_fullStr Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature
title_full_unstemmed Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature
title_short Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature
title_sort hyperammonemia what urea lly need to know case report of severe noncirrhotic hyperammonemic encephalopathy and review of the literature
url http://dx.doi.org/10.1155/2016/8512721
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