2013, Number 5
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Acta Pediatr Mex 2013; 34 (5)
Hyperamonemia in children. Study of 72 cases
Jiménez PM, Ibarra GI, Fernández LC, Ruiz GM, Vela AM
Language: Spanish
References: 20
Page: 268-274
PDF size: 150.46 Kb.
ABSTRACT
Hyperammonemia (HA) is a metabolic emergency, and when not
diagnosed and treated in a timely manner leads to severe neurological
damage and/ or death. HA may have multiple origins, but
the EIM are one of the causes that should always be suspected.
The objective of this work is to make a clinical description of the
causes of HA in a sample of patients from the National Institute of
Pediatrics (INP), to know the proportion of patients with HA in which
could confirm the presence of an inborn error of metabolism (IEM).
We found 72 patients with HA in the past 10 years, of whom 11
were patients already known to have an IEM and 61 with unknown
cause; Of the latter, 46% of patients underwent metabolic studies
(amino acids quantification, organic acids analysis and orotic acid
quantification) and in 14 cases (30%) an IEM was diagnosed. The
clinical symptoms most frequently observed were neurological
(seizures, drowsiness, lethargy, irritability, developmental delay, and
hypotonia stupor, etc.), followed by digestive disturbances such as
vomiting and refusal to eat. Urea cycle disorders, aminoacidopathies
and organic acidemias were diagnosed, so the management and
treatment of these should be known by the pediatricians, especially
those dedicated to emergencies.
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