Noncirrhotic hyperammonemia after deceased donor kidney transplantation: A case report.
Am J Transplant
; 19(11): 3197-3201, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31347272
ABSTRACT
A 72-year-old woman with end-stage kidney disease due to recurrent urinary tract infections and obstructive uropathy of a solitary kidney presented to our hospital for renal transplantation. She underwent successful transplantation of a deceased donor allograft, but developed acute mental status deterioration on the fifth postoperative day. Her serum ammonia was found to be markedly elevated to 447 µmol/L in the setting of normal hepatic function. She was treated with emergent dialysis and empiric antibiotics targeting urea-splitting organisms, and ultimately made a full neurologic recovery with stable renal allograft function. Noncirrhotic hyperammonemia (NCH) is an exceedingly rare clinical entity but seems to have a predilection for patients who have undergone solid organ transplantation. This report emphasizes the importance of rapid diagnosis and initiation of treatment for NCH, which is associated with a high rate of mortality and irreversible neurological morbidity. We outline the successful workup and management approach for this patient.
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Base de dados:
MEDLINE
Assunto principal:
Doadores de Tecidos
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Transplante de Rim
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Hiperamonemia
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Morte
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Falência Renal Crônica
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article