Reversibility of serum NH3 level in a case of sudden onset and rapidly progressive case of type 2 citrullinemia.

@article{Ishikawa2000ReversibilityOS,
  title={Reversibility of serum NH3 level in a case of sudden onset and rapidly progressive case of type 2 citrullinemia.},
  author={Fumihiko Ishikawa and M. Nakamuta and Masahiko Kato and Hideki Iwamoto and Munechika Enjoji and Yoshihiro Miyata and Toyoshi Inoguchi and Hironori Sakai and Hajime Nawata},
  journal={Internal medicine},
  year={2000},
  volume={39 11},
  pages={925-9}
}
A 48-year-old male presented with an acute change in mental status due to a marked elevation of plasma NH3 and was diagnosed with citrullinemia with amino acid analysis of blood. Hemodialysis and hemodiafiltration were performed, but serum chemical analysis did not show any improvement which led us to terminate dialysis following intensive care for 3 days. Surprisingly, NH3 level had decreased by 6 days after admission, coinciding with normalization of the size of the pupils. Since spontaneous… CONTINUE READING