Late Onset Ornithine Transcarbamylase Deficiency Triggered by an Acute Increase in Protein Intake: A Review of 10 Cases Reported in the Literature

While the urea cycle disorders (UCDs) classically present in the neonatal stage, they have become increasingly recognized as a rare cause of unexplained hyperammonemic encephalopathy in adults. Many metabolic triggers for late-onset UCDs have been described in the literature including excessive prot...

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Main Authors: E. Barkovich, A. L. Gropman
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Genetics
Online Access:http://dx.doi.org/10.1155/2020/7024735
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author E. Barkovich
A. L. Gropman
author_facet E. Barkovich
A. L. Gropman
author_sort E. Barkovich
collection DOAJ
description While the urea cycle disorders (UCDs) classically present in the neonatal stage, they have become increasingly recognized as a rare cause of unexplained hyperammonemic encephalopathy in adults. Many metabolic triggers for late-onset UCDs have been described in the literature including excessive protein intake. In this case series, ten such documented cases are reviewed with analysis of patient demographic, protein load, treatment course, and patient outcome. Common delays in treatment include recognition of hyperammonemia as the cause of encephalopathy and initiation of hemodialysis. In only one case was a diet history used to raise suspicion for a metabolic derangement. Metabolic disorders remain an important consideration in adults presenting with encephalopathy not explained by more common etiologies, and recent and remote dietary history may provide valuable information.
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spelling doaj-art-98d91a2c455f48009ef04c51c64360a92025-08-20T03:37:23ZengWileyCase Reports in Genetics2090-65442090-65522020-01-01202010.1155/2020/70247357024735Late Onset Ornithine Transcarbamylase Deficiency Triggered by an Acute Increase in Protein Intake: A Review of 10 Cases Reported in the LiteratureE. Barkovich0A. L. Gropman1Department of Radiology, George Washington University School of Medicine and Health Sciences, Washington, DC, USADepartment of Neurology, George Washington University School of Medicine and Health Sciences, Children’s National Medical Center, Washington, DC, USAWhile the urea cycle disorders (UCDs) classically present in the neonatal stage, they have become increasingly recognized as a rare cause of unexplained hyperammonemic encephalopathy in adults. Many metabolic triggers for late-onset UCDs have been described in the literature including excessive protein intake. In this case series, ten such documented cases are reviewed with analysis of patient demographic, protein load, treatment course, and patient outcome. Common delays in treatment include recognition of hyperammonemia as the cause of encephalopathy and initiation of hemodialysis. In only one case was a diet history used to raise suspicion for a metabolic derangement. Metabolic disorders remain an important consideration in adults presenting with encephalopathy not explained by more common etiologies, and recent and remote dietary history may provide valuable information.http://dx.doi.org/10.1155/2020/7024735
spellingShingle E. Barkovich
A. L. Gropman
Late Onset Ornithine Transcarbamylase Deficiency Triggered by an Acute Increase in Protein Intake: A Review of 10 Cases Reported in the Literature
Case Reports in Genetics
title Late Onset Ornithine Transcarbamylase Deficiency Triggered by an Acute Increase in Protein Intake: A Review of 10 Cases Reported in the Literature
title_full Late Onset Ornithine Transcarbamylase Deficiency Triggered by an Acute Increase in Protein Intake: A Review of 10 Cases Reported in the Literature
title_fullStr Late Onset Ornithine Transcarbamylase Deficiency Triggered by an Acute Increase in Protein Intake: A Review of 10 Cases Reported in the Literature
title_full_unstemmed Late Onset Ornithine Transcarbamylase Deficiency Triggered by an Acute Increase in Protein Intake: A Review of 10 Cases Reported in the Literature
title_short Late Onset Ornithine Transcarbamylase Deficiency Triggered by an Acute Increase in Protein Intake: A Review of 10 Cases Reported in the Literature
title_sort late onset ornithine transcarbamylase deficiency triggered by an acute increase in protein intake a review of 10 cases reported in the literature
url http://dx.doi.org/10.1155/2020/7024735
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AT algropman lateonsetornithinetranscarbamylasedeficiencytriggeredbyanacuteincreaseinproteinintakeareviewof10casesreportedintheliterature