Alan J. Watson, Judith E. Karp, W. Gordon Walker, Thomas Chambers, Victor R. Risch, Saul W. Brusilow

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Transient severe hyperammonaemia developed in the absence of serious liver dysfunction in three patients being treated for acute leukaemia. The onset of the biochemical disturbance was abrupt and led rapidly to acute encephalopathy, fatal in two cases. In the third patient, prompt initiation of aggressive haemodialysis and intravenous sodium benzoate and sodium phenylacetate infusion successfully controlled plasma ammonium levels until they spontaneously resolved. The cause of the disorder remains to be determined, but urinary nitrogen partition studies suggest temporary impairment of ureagenesis in a catabolic setting as a major pathophysiological feature of this disorder. The absence of liver disease, the normal mitochondrial ultrastructure seen in two cases, and the plasma aminoacid profiles observed serve to distinguish this disorder from others such as Reye's syndrome.

Original languageEnglish (US)
Pages (from-to)1271-1274
Number of pages4
JournalThe Lancet
Issue number8467
StatePublished - Dec 7 1985

ASJC Scopus subject areas

  • General Medicine


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