This report describes a case of transient hyperammonemia following tonic-clonic status epilepticus with an initial ammonia level of 537 Umol/L. This appears to be the highest transient ammonia level reported in the literature in this clinical scenario. This is an affirmation that an initial elevated ammonia level in the absence of hepatic dysfunction should be interpreted with caution when asso...

A 76 year old lady presented with altered sensorium and was found to have hyperammonemia on evaluation. She had no evidence of liver disease. For her symptomatology of backache, evaluation by bone marrow study showed evidence of multiple myeloma. She was given chemotherapy for multiple myeloma, which resulted in improvement in her sensorium, along with this there was also a rapid decline in ser...

Most organic acidemias become clinically apparent during neonatal period or early infancy. Infants typically have severe metabolic acidosis with increased anion gap, ketosis and hyperammonemia. Extremely high ammonia levels exceeding 1000 μmol/L is a discriminative feature for urea cycle defect while levels exceeding 200-300 μmol/L are rarely encountered in other reasons of hyperammonemia. Leth...

TOPIC: Critical Care TYPE: Fellow Case Reports INTRODUCTION: In the US prevalence of obesity has risen to 39.8% and affected about 93.3 million adults in 2015. Morbidly obese patients are increasingly pursuing bariatric surgery. While benefits surgery numerous, it is important recognize understand short term long postoperative complications. Hyperammonemic syndrome an uncommon but severe compli...

Background. Hyperammonemia resulting from chronic liver disease (CLD) can potentially challenge and damage any organ system of the body, particularly the brain. However, there is still some controversy regarding the diagnostic or prognostic values of serum ammonia in patients with over hepatic encephalopathy, especially in the setting of acute-on-chronic or chronic liver failure. Moreover, the ...