Case Report
Nonfatal Hyperammonemic Encephalopathy as a Late Complication of Roux-en-Y Gastric Bypass
Table 1
Laboratory findings during admission.
| | Laboratory | Day of Admission | Day 3 | Day 4 (discharge) | Normal range |
| | Ammonia (μmol/L) | NA | 173 | 24 | 11 - 50 μmol/L |
| | Hemoglobin (g/dL) | 10.3 | 10.5 | 10.5 | 11.1 - 14.6 g/dL |
| | Mean Corpuscular Volume | 107.5 | 106.5 | 107.9 | 79.9 - 95.0 fL |
| | Platelets (103/uL) | 152 | 179 | 341 | 140 – 400 103/uL |
| | White Blood Cells (103/uL) | 7.0 | 7.5 | 5.3 | 4.0 - 10.5 103/uL |
| | Glucose (mg/dl) | 81 | 62 | 85 | 65 - 99 mg/dL |
| | Zinc (μg/dL) | 54 | NA | NA | 56-134 μg/dL |
| | Vitamin B1 (nmol/L) | 191.9 | ND | ND | 66.5-200.5 (nmol/L) |
| | Vitamin B12 (pg/mL) | >2,000 | ND | ND | 232 - 1,245 (pg/mL) |
| | Sodium (mmol/L9 | 142 | 145 | 147 | 135 - 146 mmol/L |
| | Potassium (mmol/L) | 4.1 | 3.9 | 3.9 | 3.5 - 5.5 mmol/L |
| | Chloride (mmol/L) | 108 | 106 | 108 | 98 - 110 mmol/L |
| | CO2 (mmol/L) | 21 | 28 | 25 | 19 - 34 mmol/L |
| | Anion Gap | 13 | 11 | 14 | 6 to 22 |
| | Blood Urea Nitrogen (mg/dL) | 20 | 25 | 30 | 6 - 20 mg/dL |
| | Osmolality mOsm/Kg | 285 | 291 | 298 | 275 - 295 mOsm/kg |
| | Creatinine (mg/dL) | 1.09 | 0.77 | 0.58 | 0.40 - 1.10 mg/dL |
| | Calcium, Serum (mg/dL) | 7.8 | 7.8 | 7.8 | 8.6 - 10.3 mg/dL |
| | Protein, Total (g/dL) | 4.3 | 4.1 | 3.9 | 6.1 - 8.1 g/dL |
| | Albumin (g/dL) | 2.6 | 2.3 | 1.7 | 3.5 - 5.2 g/dL |
| | Bilirubin, Total (mg/dL) | 0.3 | 0.5 | 0.5 | 0.0 - 1.2 mg/dL |
| | AST (SGOT) (U/L) | 66 | 32 | 31 | 10 - 40 U/L |
| | ALT (SGPT) (U/L) | 70 | 55 | 50 | 0 - 33 U/L |
| | Alkaline Phosphatase (U/L) | 115 | 122 | 102 | 35 - 105 U/L |
| | Magnesium (mg/dL) | 1.7 | 1.6 | 1.8 | 1.6 - 2.6 mg/dL |
| | Prothrombin time (sec) | 20 | NA | NA | 12.0 - 14.5 sec |
| | International Normalized Ratio | 1.65 | NA | 1.1 | NA |
| | activated partial thromboplastin time (sec) | 26.1 | NA | NA | 23.7 - 35.3 sec |
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ALT, alanine aminotransferase; AST, aspartate aminotransferase; NA, not available.
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