醫學筆記匯整 ED Notes

 Increased Ammonia Production 

Infection   
 Urease producing bacteria (Proteus, Klebsiella)    
   Herpes infection    

Protein load and increased catabolism   
 Severe exercise    
 Seizures     
 Trauma or burns     
 Steroid administration     
 Chemotherapy     
 Starvation  
 Gastric bypass     

GI hemorrhage    
   Increased renal ammonia production     
   Increased splanchnic ammonia production     
   Increased peripheral catabolism
    due to deficiency of essential amino acids    
     
TPN     
Other    
 Cancers (multiple myeloma)     
     
 Decreased Ammonia Elimination 
Liver failure
 Fulminant hepatic failure
   Trans-hepatic, intrajugular

Shunt 
   Portosystemic shunt (TIPSS)

Drugs
   Glycine
 Valproate
 Carbamazepine
 Rifabutin

IEM 
   Ornithine transcarbamylase deficiency
   Carbamyl synthetase deficiency
   NAGS deficiency
   Arginosuccinate lyase deficiency
   Hyperomithinemia, hyperammonemia, homocitrillinuria
   Lysinuric protein intolerance
   Organic acidurias
   Fatty acid oxidation defects

Other 
   IHA

Hyperammonemia in the ICU 2007