Kiberenge Roy K, Lam Humphrey
Department of Anesthesiology, University of Iowa, Iowa City, IA, USA.
Pediatric Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.
J Clin Anesth. 2015 Mar;27(2):164-7. doi: 10.1016/j.jclinane.2014.09.008. Epub 2015 Jan 5.
A 35-year-old man had symptomatic hyperammonemia and normal liver function after repeat kidney transplantation. He presented with gastrointestinal symptoms, which quickly progressed to altered mental status. Therapy was instituted to clear the ammonia, but the ammonia level continued to rise. Eventually, the patient became unresponsive, and an emergent computed tomographic scan showed cerebral herniation. Urine acids and serum organic acids were not diagnostic of any urea cycle disorder. Histology did not reveal a clear etiology for the hyperammonemia.
一名35岁男性在再次肾移植后出现有症状的高氨血症，肝功能正常。他出现胃肠道症状，并迅速发展为精神状态改变。采取了清除氨的治疗措施，但氨水平持续上升。最终，患者失去反应，急诊计算机断层扫描显示脑疝。尿酸和血清有机酸检查未诊断出任何尿素循环障碍。组织学检查未发现高氨血症的确切病因。
