Abstract
When other signs or symptoms are absent, cyclic vomiting in young children frequently results in psychiatric referral that proves ineffectual. Clinical experience with two female grade school children with cyclic vomiting and hyperammonemia suggests an organic etiology. Protein loading studies in these children provoked hyperammonemia, orotic aciduria, and hyperaminoacidemia consistent with the diagnosis of OCT deficiency. Protein restriction resulted in clinical improvement and was well tolerated. We suggest that, when severe cyclic vomiting occurs in female children, the possibility of OCT deficiency should be considered before psychiatric referral.
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