Successful Treatment of Hyperammonemia after Lung Transplantation (1998)

Letters1 June 1998Successful Treatment of Hyperammonemia after Lung TransplantationJose F. Rueda, MD, Cary Caldwell, MD, and Daniel C. Brennan, MDJose F. Rueda, MDBarnes-Jewish Hospital; St. Louis, MO 63110, Cary Caldwell, MDBarnes-Jewish Hospital; St. Louis, MO 63110, and Daniel C. Brennan, MDBarnes-Jewish Hospital; St. Louis, MO 63110Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-11-199806010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Tuchman and colleagues recently reported the association of hepatic glutamine synthetase deficiency and fatal hyperammonemia after lung transplantation in two patients [1, 2]. To date, no reports have described successful treatment of this syndrome in lung transplant recipients.We report the successful treatment of hyperammonemia in a 46-year-old man who developed severe emphysema secondary to α1-antitrypsin and underwent bilateral orthotopic lung transplantation. Immunosuppressive therapy included azathioprine, cyclosporine, antithymocyte globulin, and methylprednisolone. Nine days after surgery, the patient became agitated and restless; he progressed to coma with decerebrate posturing within 12 hours. The patient was febrile (temperature, 38.5°C), ...References1. Tuchman M, Lichtenstein GR, Rajagopal BS, McCann MT, Furth EE, Bavaria J, et al. Hepatic glutamine synthetase deficiency in fatal hyperammonemia after lung transplantation. Ann Intern Med. 1997; 127:446-9. Google Scholar2. Kaveggia FF, Thompson JS, Schafer EC, Fischer JL, Taylor RJ. Hyperammonemia encephalopathy in urinary diversion with urea-splitting urinary tract infection. Arch Intern Med. 1990; 150:2389-92. Google Scholar3. Batshaw ML. Inborn errors of urea synthesis. Ann Neurol. 1994; 35:133-41. Google Scholar Author, Article, and Disclosure InformationAffiliations: Barnes-Jewish Hospital; St. Louis, MO 63110 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAssociation between Mycoplasma and Ureaplasma airway positivity, ammonia levels, and outcomes post–lung transplantation: A prospective surveillance studyProphylactic Ureaplasma-directed Antimicrobials in Lung Donors Can Prevent Fatal HyperammonemiaImpact of Screening and Treatment of Ureaplasma species on Hyperammonemia Syndrome in Lung Transplant Recipients: A Single Center ExperienceHyperammonemia Presenting as Refractory Status Epilepticus after Lung Transplant in a Patient Positive for Ureaplasma parvumNeurologic Complications of Solid Organ TransplantationUreaplasma urealyticum Causes Hyperammonemia in an Experimental Immunocompromised Murine ModelHyperammonemia Syndrome After Lung TransplantationSymptomatic hyperammonemia after lung transplantation: Lessons learntStudies on Ammocytes: Development, Metabolic Characteristics, and Detoxication of AmmoniumSuccessful Management of Immunosuppression in a Patient With Severe Hyperammonemia After Lung TransplantationCritical Care Aspects of Lung Transplant PatientsFatal Hyperammonemia after Orthotopic Lung TransplantationGary R. Lichtenstein, MD, Yu-Xiao Yang, MD, Frederick A. Nunes, MD, James D. Lewis, MD, Mendel Tuchman, MD, Gregory Tino, MD, Larry R. Kaiser, MD, Harold I. Palevsky, MD, Robert M. Kotloff, MD, Emma E. Furth, MD, Joseph E. Bavaria, MD, Mark M. Stecker, MD, Paige Kaplan, MD, and Gerard T. Berry, MDTratamiento postoperatorio del trasplante pulmonar 1 June 1998Volume 128, Issue 11Page: 956-957KeywordsAmmoniaArginineBilirubinBlood plasmaGlutamineLung transplantationRespiratory system proceduresSodiumUreasesVancomycin Issue Published: 1 June 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...