Abstract
L-asparaginase has been an important agent of acute lymphoblastic leukemia (ALL) therapy for more than 40 years. The major adverse events of L-asparaginase are immunoallergic reaction, pancreatitis, liver cytolysis (increased ASAT, ALAT, and bilirubin), and cerebral haemorrhage or thrombosis. Hyperammonemia has already been described with L -asparaginase treatment [1]. In the present article, we report acute metabolic encephalopathy in two young boys receiving asparaginase for B ALL relapse. We discuss the pathophysiology of this metabolic encephalopathy with hyperammonemia and its medical management.
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