Idiopathic Hyperammonemia: A Rare Complication Following Allogeneic Bone Marrow Transplantation.
- Author:
Hyung Soo WI
1
;
Inho KIM
;
Ki Chang KIM
;
Jane SHIN
;
Moon Hee LEE
;
Yeonsook MOON
;
Chul Soo KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea. ikim@inha.ac.kr
- Publication Type:Case Report
- Keywords:
Hyperammonenia;
Idiopathic;
Bone marrow transplantation
- MeSH:
Adult;
Ammonia;
Ataxia;
Bone Marrow Transplantation*;
Bone Marrow*;
Carnitine;
Drug Therapy;
Female;
Flumazenil;
Hallucinations;
Hematologic Neoplasms;
Humans;
Hyperammonemia*;
Lactulose;
Lethargy;
Metronidazole;
Philadelphia Chromosome;
Precursor Cell Lymphoblastic Leukemia-Lymphoma;
Renal Dialysis;
Stupor;
Transaminases
- From:Korean Journal of Medicine
2004;67(Suppl 3):S831-S835
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Idiopathic hyperammonemia is a rare and serious complication of intensive cytoreductive chemotherapy for hematologic malignancies as well as after autologus or allogeneic bone marrow transplantation (BMT). A 42-year-old woman with Philadelphia chromosome positive acute lymphoblastic leukemia was undertaken unrelated BMT. Fourteen days later, the patient developed hallucination, mental confusion, lethargy, incoordination and stupor. Laboratory tests revealed normal serum aminotransferases. The serum ammonia level is moderately increased. Parenteral alimentation was discontinued to lower protein intake and treatment with lactulose, metronidazole, carnitine, and flumazenil was started. Also, hemodialysis was performed. Despite of these appropriate therapies, she died of idiopathic hyperammonenia at twenty-two days after allogeneic BMT.
