Back to Journals » The Application of Clinical Genetics » Volume 1

Hemodialysis for hyperammonemia associated with ornithine transcarbamylase deficiency

Authors Collen JF, Das NP, Koff JM, Neff RT, Abbott KC

Published 24 July 2008 Volume 2008:1 Pages 1—5

DOI https://doi.org/10.2147/TACG.S3536

Review by Single-blind

Peer reviewer comments 2


Jacob F Collen, Nealanjon P Das, Jonathan M Koff, Robert T Neff, Kevin C Abbott

Walter Reed Army Medical Center, Washington, DC, USA

Abstract: Acute hyperammonemia is a medical emergency requiring rapid recognition and treatment to prevent devastating neurologic sequelae. Its varying etiologies include primary hepatic failure, drug toxicity, infection, and inherited disorders of metabolism. Ornithine transcarbamylase (OTC) deficiency is the most common inherited urea cycle disorder and can result in hyperammonemic encephalopathy and coma, often presenting in the newborn or early childhood. Partial deficiencies of the enzyme can present later in adulthood with protean neuropsychiatric signs and symptoms. Early recognition and management of metabolic encephalopathy is crucial to avoid neurologic damage, and may require hemodialysis for rapid removal of ammonia, with adjunctive medications and dietary modifications to decrease endogenous nitrogen production and activate alternate pathways of nitrogen excretion. We present the case of an adult patient with partial OTC deficiency who presented with encephalopathy, coma, and seizures, accompanied by hyperammonemia and treated acutely with hemodialysis.

Keywords: ornithine transcarbamylase deficiency (OTC), hemodialysis, hyperammonemia, urea cycle, ammonul

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]