Multifactorial non-cirrhotic hyperammonaemic encephalopathy
A 51-year-old female presented with acute confusion associated with a non-specific headache and lethargy. The patient's history included bipolar disorder on valproate and recent travel to northern Vietnam. The patient was subsequently found to have hyperammonaemia as well as a urinary tract inf...
| Main Authors: | , , |
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| Format: | Journal Article |
| Published: |
British Medical Journal Publishing Group
2018
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| Online Access: | http://hdl.handle.net/20.500.11937/67879 |
| _version_ | 1848761683285114880 |
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| author | Triplett, K. Murray, R. Anstey, Matthew |
| author_facet | Triplett, K. Murray, R. Anstey, Matthew |
| author_sort | Triplett, K. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | A 51-year-old female presented with acute confusion associated with a non-specific headache and lethargy. The patient's history included bipolar disorder on valproate and recent travel to northern Vietnam. The patient was subsequently found to have hyperammonaemia as well as a urinary tract infection and bacteraemia with Klebsiellapneumoniae. The patient was presumed to have a multifactorial non-cirrhotic hyperammonaemic encephalopathy due to a combination of a urinary tract infection and bacteraemia with K. pneumoniae, a urease-producing bacteria, and also valproate use, a medication known to interfere with ammonia elimination. The patient's treatment included supportive care, ceasing valproate, empiric then rationalised antibiotics, N-acetylcysteine and L-carnitine. We present a case of non-cirrhotic hyperammonaemic encephalopathy and explain why it is multifactorial in origin. |
| first_indexed | 2025-11-14T10:35:34Z |
| format | Journal Article |
| id | curtin-20.500.11937-67879 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:35:34Z |
| publishDate | 2018 |
| publisher | British Medical Journal Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-678792018-09-19T01:40:35Z Multifactorial non-cirrhotic hyperammonaemic encephalopathy Triplett, K. Murray, R. Anstey, Matthew A 51-year-old female presented with acute confusion associated with a non-specific headache and lethargy. The patient's history included bipolar disorder on valproate and recent travel to northern Vietnam. The patient was subsequently found to have hyperammonaemia as well as a urinary tract infection and bacteraemia with Klebsiellapneumoniae. The patient was presumed to have a multifactorial non-cirrhotic hyperammonaemic encephalopathy due to a combination of a urinary tract infection and bacteraemia with K. pneumoniae, a urease-producing bacteria, and also valproate use, a medication known to interfere with ammonia elimination. The patient's treatment included supportive care, ceasing valproate, empiric then rationalised antibiotics, N-acetylcysteine and L-carnitine. We present a case of non-cirrhotic hyperammonaemic encephalopathy and explain why it is multifactorial in origin. 2018 Journal Article http://hdl.handle.net/20.500.11937/67879 10.1136/bcr-2017-223245 British Medical Journal Publishing Group restricted |
| spellingShingle | Triplett, K. Murray, R. Anstey, Matthew Multifactorial non-cirrhotic hyperammonaemic encephalopathy |
| title | Multifactorial non-cirrhotic hyperammonaemic encephalopathy |
| title_full | Multifactorial non-cirrhotic hyperammonaemic encephalopathy |
| title_fullStr | Multifactorial non-cirrhotic hyperammonaemic encephalopathy |
| title_full_unstemmed | Multifactorial non-cirrhotic hyperammonaemic encephalopathy |
| title_short | Multifactorial non-cirrhotic hyperammonaemic encephalopathy |
| title_sort | multifactorial non-cirrhotic hyperammonaemic encephalopathy |
| url | http://hdl.handle.net/20.500.11937/67879 |