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Ann Fr Anesth Reanim. 2002 Dec;21(10):820-3.

[Fulminant coma: think hyperammonemia and urea cycle disorders].

[Article in French]

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  • 1Service d'anesthésie, centre hospitalier de Nevers, avenue Colbert, 58000 Nevers, France.


The authors report the case of 14-year-old boy admitted for acute coma without neurological focal symptom. The only relevant finding was the death of one uncle after a coma in the year 1992. This coma was associated with an ammonia blood level of 344 mumol l-1 and it rapidly lead to cerebral death despite a symptomatic treatment. The diagnosis of hereditary ornithine transcarbamylase deficiency was confirmed by liver biopsy in the immediate post-mortem period. The authors recommend the measurement of blood ammonia in every coma without diagnosis, whatever patient's age.

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