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急诊科一例癫痫持续状态相关的短暂性高氨血症病例

A Case of Status-Epilepticus-Associated Transient Hyperammonemia in the Emergency Department.

作者信息

Pelsue Brittany, Rogg Jonathan G

机构信息

Department of Pharmacy, Memorial Hermann-Texas Medical Center, 6411 Fannin Street, Houston, TX 77030, USA.

出版信息

Case Rep Emerg Med. 2017;2017:9436095. doi: 10.1155/2017/9436095. Epub 2017 Dec 24.

Abstract

This report describes a case of transient hyperammonemia following tonic-clonic status epilepticus with an initial ammonia level of 537 Umol/L. This appears to be the highest transient ammonia level reported in the literature in this clinical scenario. This is an affirmation that an initial elevated ammonia level in the absence of hepatic dysfunction should be interpreted with caution when associated with status epilepticus. Repeat levels should be drawn to identify transient hyperammonemia and determine the need for treatment if levels do not decrease.

摘要

本报告描述了一例强直阵挛性癫痫持续状态后出现短暂高氨血症的病例,初始氨水平为537μmol/L。这似乎是该临床情况下文献报道的最高短暂氨水平。这证实了在无肝功能障碍的情况下,当与癫痫持续状态相关时,初始升高的氨水平应谨慎解读。应复查血氨水平以识别短暂高氨血症,并在血氨水平未下降时确定是否需要治疗。

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本文引用的文献

1
Methamphetamine Intoxication Encephalopathy Associated With Hyperammonemia.与高氨血症相关的甲基苯丙胺中毒性脑病
Psychosomatics. 2016 May-Jun;57(3):325-9. doi: 10.1016/j.psym.2015.12.011. Epub 2015 Dec 31.
2
Transient hyperammonemia in seizures: a prospective study.发作性一过性高氨血症:一项前瞻性研究。
Epilepsia. 2011 Nov;52(11):2043-9. doi: 10.1111/j.1528-1167.2011.03279.x. Epub 2011 Oct 5.
3
Hyperammonemia in review: pathophysiology, diagnosis, and treatment.高血氨血症综述:病理生理学、诊断和治疗。
Pediatr Nephrol. 2012 Feb;27(2):207-22. doi: 10.1007/s00467-011-1838-5. Epub 2011 Mar 23.
4
Postictal transient hyperammonemia.发作后短暂性高氨血症
Am J Emerg Med. 2008 Mar;26(3):388.e1-2. doi: 10.1016/j.ajem.2007.07.031.
6
Biochemistry and physiology of brain ammonia.脑氨的生物化学与生理学
Physiol Rev. 1987 Apr;67(2):440-519. doi: 10.1152/physrev.1987.67.2.440.

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