Multifactorial non-cirrhotic hyperammonaemic encephalopathy.

A 51-year-old female presented with acute confusion associated with a non-specific headache and lethargy. The patient''s history included bipolar disorder on valproate and recent travel to northern Vietnam. The patient was subsequently found to have hyperammonaemia as well as a urinary tract infecti...

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Publicado en:BMJ Case Reports Vol. 2018; pp. 1 - 4
Autores principales: Triplett, Katherine Elizabeth, Murray, Ronan, Anstey, Matthew
Formato: Journal Article
Publicado: BMJ Publishing Group 3/9/2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 3/9/2018
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      pub: BMJ Publishing Group
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        128546487
        10.1136/bcr-2017-223245
        128546487
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        atl: Multifactorial non-cirrhotic hyperammonaemic encephalopathy.
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        au:
          Triplett, Katherine Elizabeth
          Murray, Ronan
          Anstey, Matthew
        affil: Intensive Care, Sir Charles Gairdner Hospital, Nedlands, Australia
      sug:
      ab: A 51-year-old female presented with acute confusion associated with a non-specific headache and lethargy. The patient''s history included bipolar disorder on valproate and recent travel to northern Vietnam. The patient was subsequently found to have hyperammonaemia as well as a urinary tract infection and bacteraemia with Klebsiellapneumoniae. The patient was presumed to have a multifactorial non-cirrhotic hyperammonaemic encephalopathy due to a combination of a urinary tract infection and bacteraemia with K. pneumoniae, a urease-producing bacteria, and also valproate use, a medication known to interfere with ammonia elimination. The patient's treatment included supportive care, ceasing valproate, empiric then rationalised antibiotics, N-acetylcysteine and L-carnitine. We present a case of non-cirrhotic hyperammonaemic encephalopathy and explain why it is multifactorial in origin.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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