Korean J Med.  2004 Nov;67(Suppl 3):S831-S835.

Idiopathic Hyperammonemia: A Rare Complication Following Allogeneic Bone Marrow Transplantation

• Wi HS
• Kim I
• Kim KC
• Shin J
• Lee MH
• Moon Y
• Kim CS

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.

Keyword

Hyperammonenia; Idiopathic; Bone marrow transplantation

MeSH Terms

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
Ammonia
Carnitine
Flumazenil
Lactulose
Metronidazole
Transaminases