Sirotik olmayan hiperamoniemi, 43 yıl önce üriner derivasyon yapılan bir hastada, değişmiş duyarlığa neden oldu.
Abstract
Doğuştan ürolojik defektlerin veya mesane kanserinin tedavisi için yapılan bir üriner diversiyon prosedürü olan Ureterosigmoidostomi, eşlik eden karaciğer hastalığının yokluğunda bile nadiren hiperammonemi ile seyredebilir. Burada, üreterosigmoidostomi sonrası 43 yıl hiperammonik ensefalopati gelişen 47 yaşında bir erkek hastayı sunuyoruz. Bu nedenle, üreteroopigmoidostomi sonrası hiperammonemik ensefalopati, kritik bakım ortamlarında değişmiş bilinçliliğin ayırıcı tanısında dikkate alınması gereken iyatrojenik, ancak tedavi edilebilir bir problemdir.
References
- 1. Van der Aa F, Joniau S, Branden MVD, Poppel HV. Metabolic Changes after Urinary Diversion. Adv Urol. 2011;2011:764325. PMID: 21687576
- 2. Upadhyay R, Bleck TP, Busl KM. Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature. Case Rep Med. 2016;2016:8512721. PMID: 27738433
- 3. Cascino GD, Jensen JM, Nelson LA, Schu a HS. Periodic hyperammonemic encephalopathy associated with a ureterosigmoidostomy. Mayo Clin Proc 1989; 64: 653-6. PMID: 2747294
- 4. Jäger W, Viertmann A-O, Janßen C, Birklein F, Thüro J, Raimund R. Intermittent hyperammonemic encephalopathy after ureterosigmoidostomy: spontaneous onset in the absence of hepatic failure. Cent European J Urol 2015; 68: 121-124. PMID: 25914851
- 5. Wilkinson DJ, Smeeton NJ, Wa PW. Ammonia metabolism, the brain and fatigue; revisiting the link. Prog Neurobiol 2010; 91: 200-19. PMID: 20138956
Non-cirrhotic Hyperammonemia causing altered sensorium in a patient who underwent Urinary diversion 43 years ago.
Abstract
Ureterosigmoidostomy, a urinary diversion procedure performed for treatment of congenital urologic defects or bladder cancer, can rarely presents with hyperammonemia even in the absence of coexistent liver disease. Here, we report the case of a 47-year-old man who developed hyperammonic encephalopathy 43 years after ureterosigmoidostomy. Therefore, hyperammonemic encephalopathy after ureterosigmoidostomy is an iatrogenic, but treatable problem which must be considered in the differential diagnosis of altered consciousness in the critical care settings.
Keywords
References
- 1. Van der Aa F, Joniau S, Branden MVD, Poppel HV. Metabolic Changes after Urinary Diversion. Adv Urol. 2011;2011:764325. PMID: 21687576
- 2. Upadhyay R, Bleck TP, Busl KM. Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature. Case Rep Med. 2016;2016:8512721. PMID: 27738433
- 3. Cascino GD, Jensen JM, Nelson LA, Schu a HS. Periodic hyperammonemic encephalopathy associated with a ureterosigmoidostomy. Mayo Clin Proc 1989; 64: 653-6. PMID: 2747294
- 4. Jäger W, Viertmann A-O, Janßen C, Birklein F, Thüro J, Raimund R. Intermittent hyperammonemic encephalopathy after ureterosigmoidostomy: spontaneous onset in the absence of hepatic failure. Cent European J Urol 2015; 68: 121-124. PMID: 25914851
- 5. Wilkinson DJ, Smeeton NJ, Wa PW. Ammonia metabolism, the brain and fatigue; revisiting the link. Prog Neurobiol 2010; 91: 200-19. PMID: 20138956
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Case Report |
| Authors | |
| Publication Date | April 25, 2019 |
| Submission Date | October 9, 2018 |
| Acceptance Date | March 22, 2019 |
| Published in Issue | Year 2019 |
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