Case Report
Fatal Nonhepatic Hyperammonemia in ICU Setting: A Rare but Serious Complication following Bariatric Surgery
Table 3
Differential diagnosis of nonhepatic hyperammonemia based on [
3–
8].
| SN | Ddx | Characteristics |
| 1 | Medications | Valproic acid, 5-FU |
| 2 | Infections | Urease-producing bacteria: | (i) Proteus mirabilis | (ii) Helicobacter pylori | (iii) Cornebacterium, Klebsiella, and Morganella species |
| 3 | Surgery | (i) Lung transplant | (ii) Bone marrow transplant | (iii) Ureterosigmoidoscopy | (iv) Portosystemic shunts | (v) Bariatric surgery |
| 4 | Hyperalimentation | Increased nitrogen load in patient receiving parental nutrition |
| 5 | Errors in metabolism | | (a) Fatty acid oxidation defects | | (b) Urea cycle enzyme defects | | (c) Amino acid disorders | |
| 6 | Gastrointestinal bleeding | |
| 7 | Carnitine deficiency | |
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