Abstract
Hyperammonemia syndrome is one of the causes of metabolic encephalopathy that is rarely observed after high dose chemotherapy for the treatment of hematologic malignancies. Two cases, who developed neurologic symptoms and coma due to hyperammonemia subsequent to chemotherapy for Burkitt’s lymphoma and acute myeloid leukemia, respectively are being presented in this report. In case respiratory alkalosis, unexplained neurological symptoms and mental status changes develop after intensive chemotherapy, hyperammonemia should come into mind, and the serum ammonium level should be measured to implement ammonium-lowering therapy.
Highlights
The ammonium is a form of nitrogen that originates from proteins metabolized by bacteria in the intestine
Hyperammonemia syndrome is one of the causes of metabolic encephalopathy that is rarely observed after high-dose chemotherapy for the treatment of hematologic malignancies
High levels of ammonia after chemotherapy were reported in the literature in patients with acute leukemia (AML and acute lymphoblastic leukemia (ALL))
Summary
The ammonium is a form of nitrogen that originates from proteins metabolized by bacteria in the intestine. If the liver cannot convert ammonium to urea, hyperammonemia leads to metabolic disorders and organ dysfunction. Hyperammonemia syndrome is one of the causes of metabolic encephalopathy that is rarely observed after high-dose chemotherapy for the treatment of hematologic malignancies. The findings were normal by abdomen ultrasonography Those signs were thought to develop due to the toxicity of chemotherapy. Blood ammonia values were measured between 350-500 mmol/L (normal upper limit of 35 mmol/L) in different times. Fever was 39°C about 10-12 days after chemotherapy and he received antibiotic therapy. Confusion developed and his consciousness gradually closed down within 3 days. Blood ammonia levels were measured between 400 to 600 mmol/ L (normal upper limit of 35 mmol/ L) in different times. Clinical and laboratory findings of patient have recovered after one month of second admission
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Schedule a callMore From: International Journal of Cancer Research and Molecular Mechanisms ( ISSN 2381-3318 )
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