Fatal Hyperammonemia in a Patient with Systemic Lupus Erythematosus.

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  • ICHIKAWA Haruo
    The Department of Medicine III, Okayama University Medical School
  • AMANO Tetsuki
    The Department of Medicine III, Okayama University Medical School
  • KAWABATA Kenji
    The Department of Medicine III, Okayama University Medical School
  • KUSHIRO Masahiko
    The Department of Medicine III, Okayama University Medical School
  • WADA Jun
    The Department of Medicine III, Okayama University Medical School
  • NAGAKE Yoshio
    The Department of Medicine III, Okayama University Medical School
  • MAKING Hirofumi
    The Department of Medicine III, Okayama University Medical School

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  • Fatal Hyperammonemia in a Patient with

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Abstract

We treated a 31-year-old woman with systemic lupus erythematosus, renal failure with nephrotic syndrome, and a long-standing seizure disorder, who developed severe hyperammonemia with a fatal outcome. Blood chemistry examination did not indicate liver disease, and amino acid concentrations did not suggest a defect in the urea cycle. Discontinuation of anticonvulsant treatment with valproic acid (VPA) failed to bring about improvement. We speculated that hyperanimonemia in this case was induced by VPA, and the existence of other underlying factors, including the administration of aspirin and cimetidine, hypoalbuminemia, and renal failure might elevate the concentration of the serum free fraction of VPA.<br>(Internal Medicine 37: 700-703, 1998)

Journal

  • Internal Medicine

    Internal Medicine 37 (8), 700-703, 1998

    The Japanese Society of Internal Medicine

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