Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website https://www.gastrores.org

Case Report

Volume 16, Number 4, August 2023, pages 244-248

Coma With Hyperammonemia in a Patient With Kwashiorkor

Figures

Figure 1.
Figure 1. Evolution of plasma ammonia level during ICU stay and treatment for controlling the hyperammonemia. ICU: intensive care unit.
Figure 2.
Figure 2. Evolution of Plasma Amino Acids Concentration During ICU Stay.
Figure 3.
Figure 3. The urea cycle: our hypothesis to explain hyperammonemia related to a urea cycle disorder and a deficiency in N-acetylglutamate.

Table

Table 1. Description of Plasma Concentration of Biological Variables at ICU Admission
 
Biological variablesPlasma concentrationNormal range
ALT: alanine aminotransferase; AST: aspartate aminotransferase; ICU: intensive care unit; INR: international normalized ratio.
Hemoglobin9.212 - 16 g/dL
Mean corpuscular volume11380 - 100 fL
Platelet count63150 - 450 g/L
White blood cell count174 - 10 g/L
Prothrombin time ratio2770-120%
INR2.27
Factor II2870-120%
Factor V5270-120%
Factor VII1070-120%
Factor VIII> 480%
Factor IX4670-150%
Factor X2370-120%
Sodium150136 - 145 mmol/L
Potassium2.73.5 - 4.8 mmol/L
Total protein4260 - 78 g/L
Albumin1635 - 50 g/L
Urea3.02.1 - 7.1 mmol/L
Creatinine51.149 - 90 µmol/L
AST595 - 34 U/L
ALT100 - 55 U/L
Zinc411 - 18 µmol/L
Ionized calcium1.001.15 - 1.29 mmol/L
Phosphate0.720.74 - 1.52 mmol/L
Magnesium0.900.66 - 1.07 mmol/L
Haptoglobin0.670.35 - 2.50 g/L
Total cholesterol0.301.4 - 2 g/L
Triglycerides0.380 - 1.7 g/L