Hyperammonemia: Difference between revisions
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**Diseases that result in [[liver failure]] | **Diseases that result in [[liver failure]] | ||
**Medications (e.g. [[valproic acid]] overdose) | **Medications (e.g. [[valproic acid]] overdose) | ||
*Severe dehydration (from small intestinal bacterial overgrowth) | **Severe dehydration (from small intestinal bacterial overgrowth) | ||
*Glycine toxicity (CNS symptoms and nausea) | **Glycine toxicity (CNS symptoms and nausea) | ||
*Congenital | *Congenital | ||
**Genetic | **Genetic | ||
Revision as of 10:43, 18 July 2020
Background
Pathophysiology
- Acquired: liver failure results in shunting of blood from the liver to the inferior vena cava, decreased filtration of blood and removal of nitrogen-containing toxins by the liver, and then hyperammonemia.
- Congenital: Defect in one of the enzymes of the urea cycle, which leads to lower production of urea from ammonia.
Types
Primary vs. secondary
- Primary
- Caused by several inborn errors of metabolism
- Characterized by reduced activity of urea cycle enzymes
- Secondary
- Caused by inborn errors of intermediary metabolism (i.e. reduced activity of enzymes that are not part of the urea cycle)
- Normally from acute or chronic liver failure
- Caused by inborn errors of intermediary metabolism (i.e. reduced activity of enzymes that are not part of the urea cycle)
Acquired vs. congenital
- Acquired
- Diseases that result in liver failure
- Medications (e.g. valproic acid overdose)
- Severe dehydration (from small intestinal bacterial overgrowth)
- Glycine toxicity (CNS symptoms and nausea)
- Congenital
- Genetic