TY - JOUR
T1 - Multifactorial non-cirrhotic hyperammonaemic encephalopathy
AU - Triplett, Katherine Elizabeth
AU - Murray, Ronan
AU - Anstey, Matthew
N1 - © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
PY - 2018/3/9
Y1 - 2018/3/9
N2 - 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 withKlebsiellapneumoniaeThe patient was presumed to have a multifactorial non-cirrhotic hyperammonaemic encephalopathy due to a combination of a urinary tract infection and bacteraemia withK. 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.
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 withKlebsiellapneumoniaeThe patient was presumed to have a multifactorial non-cirrhotic hyperammonaemic encephalopathy due to a combination of a urinary tract infection and bacteraemia withK. 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.
UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85043538591&origin=resultslist&sort=plf-f&src=s&st1=Multifactorial+non-cirrhotic+hyperammonaemic+encephalopathy&st2=&sid=8234c1276d0a37b558ec86d5adb38d7d&sot=b&sdt=b&sl=74&s=TITLE-ABS-KEY%28Multifactorial+non-cirrhotic+hyperammonaemic+encephalopathy%29&relpos=0&citeCnt=0&searchTerm=
U2 - 10.1136/bcr-2017-223245
DO - 10.1136/bcr-2017-223245
M3 - Article
C2 - 29523611
SN - 1757-790X
VL - 2018
JO - BMJ Case Reports
JF - BMJ Case Reports
M1 - 223245
ER -