Adult-Onset Ornithine Transcarbamylase Deficiency in a 51-Year-Old Man Who Presented With Fatal Hyperammonemic Encephalopathy

Typical male patients with ornithine transcarbamylase deficiency present in their early years with lethargy, seizure, and coma from hyperammonemia. An adult-onset phenotype, with sudden severe hyperammonemia emerging in otherwise-healthy men, has been increasingly recognized. We describe a character...

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Main Authors: Bun Sheng, Ka Fai Yim, Tiffany Yan Lok Lam, Candace Yim Chan, Hencher Han Chih Lee
Format: Article
Language:English
Published: American College of Physicians 2024-05-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2023.1399
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author Bun Sheng
Ka Fai Yim
Tiffany Yan Lok Lam
Candace Yim Chan
Hencher Han Chih Lee
author_facet Bun Sheng
Ka Fai Yim
Tiffany Yan Lok Lam
Candace Yim Chan
Hencher Han Chih Lee
author_sort Bun Sheng
collection DOAJ
description Typical male patients with ornithine transcarbamylase deficiency present in their early years with lethargy, seizure, and coma from hyperammonemia. An adult-onset phenotype, with sudden severe hyperammonemia emerging in otherwise-healthy men, has been increasingly recognized. We describe a characteristic clinical course in a 51-year-old Chinese man who developed fatal hyperammonemia after receiving systemic corticosteroid for Bell's palsy. The genetic sequencing detected a novel missense variant NM_000531.6:c.642C>A (p.His214Gln) in the OTC gene. Inherited urea cycle disorders should be suspected in unexplained hyperammonemia at all ages with aggressive treatment initiated promptly before a diagnosis is confirmed.
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institution OA Journals
issn 2767-7664
language English
publishDate 2024-05-01
publisher American College of Physicians
record_format Article
series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-578f529fc2de45c5ac8bd44daf9b41e92025-08-20T02:27:20ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-05-013510.7326/aimcc.2023.1399Adult-Onset Ornithine Transcarbamylase Deficiency in a 51-Year-Old Man Who Presented With Fatal Hyperammonemic EncephalopathyBun Sheng0Ka Fai Yim1Tiffany Yan Lok Lam2Candace Yim Chan3Hencher Han Chih Lee41Department of Medicine & Geriatrics, Princess Margaret Hospital, Hong Kong1Department of Medicine & Geriatrics, Princess Margaret Hospital, Hong Kong1Department of Medicine & Geriatrics, Princess Margaret Hospital, Hong Kong2Department of Pathology, Princess Margaret Hospital, Hong Kong2Department of Pathology, Princess Margaret Hospital, Hong KongTypical male patients with ornithine transcarbamylase deficiency present in their early years with lethargy, seizure, and coma from hyperammonemia. An adult-onset phenotype, with sudden severe hyperammonemia emerging in otherwise-healthy men, has been increasingly recognized. We describe a characteristic clinical course in a 51-year-old Chinese man who developed fatal hyperammonemia after receiving systemic corticosteroid for Bell's palsy. The genetic sequencing detected a novel missense variant NM_000531.6:c.642C>A (p.His214Gln) in the OTC gene. Inherited urea cycle disorders should be suspected in unexplained hyperammonemia at all ages with aggressive treatment initiated promptly before a diagnosis is confirmed.https://www.acpjournals.org/doi/10.7326/aimcc.2023.1399
spellingShingle Bun Sheng
Ka Fai Yim
Tiffany Yan Lok Lam
Candace Yim Chan
Hencher Han Chih Lee
Adult-Onset Ornithine Transcarbamylase Deficiency in a 51-Year-Old Man Who Presented With Fatal Hyperammonemic Encephalopathy
Annals of Internal Medicine: Clinical Cases
title Adult-Onset Ornithine Transcarbamylase Deficiency in a 51-Year-Old Man Who Presented With Fatal Hyperammonemic Encephalopathy
title_full Adult-Onset Ornithine Transcarbamylase Deficiency in a 51-Year-Old Man Who Presented With Fatal Hyperammonemic Encephalopathy
title_fullStr Adult-Onset Ornithine Transcarbamylase Deficiency in a 51-Year-Old Man Who Presented With Fatal Hyperammonemic Encephalopathy
title_full_unstemmed Adult-Onset Ornithine Transcarbamylase Deficiency in a 51-Year-Old Man Who Presented With Fatal Hyperammonemic Encephalopathy
title_short Adult-Onset Ornithine Transcarbamylase Deficiency in a 51-Year-Old Man Who Presented With Fatal Hyperammonemic Encephalopathy
title_sort adult onset ornithine transcarbamylase deficiency in a 51 year old man who presented with fatal hyperammonemic encephalopathy
url https://www.acpjournals.org/doi/10.7326/aimcc.2023.1399
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