A Case of Hyperammonemia Associated with High Dihydropyrimidine Dehydrogenase Activity

Table 1

Laboratory findings.

	Day of onset	The following day	[Normal range]
[Peripheral blood]
WBC	8080/µL	5180/µL	3500–9000/µL
RBC	382 × 10^4/µL	414 × 10^4/µL	376–500 × 10^4/µL
Hb	15.3 g/dL	12.9 g/dL	11.3–15.2 g/dL
Ht	33.3%	37.0%	33.4–44.9%
MCV	87.2 fL	89.4 fL	82.7–101 fL
Plt	26.3 × 10^4/µL	25.6 × 10^4/µL	13.0–36.9 × 10^4/µL
Coagulation test
APTT	31.0 sec		25.0–45.0 sec
PT	14.2 sec		13.5–15.0 sec
D-dimer	0.66 µg/mL		<0.50 µg/mL
Biochemistry
TP	6.2 g/dL	5.6 g/dL	6.5–8.5 g/dL
Alb	3.4 g/dL	3.4 g/dL	4.1–5.3 g/dL
AST	20 IU/L	20 IU/L	10–35 IU/L
ALT	25 IU/L	23 IU/L	10–35 IU/L
LDH	182 IU/L	155 IU/L	110–225 IU/L
γ-GTP		50 IU/L	8–60 IU/L
T-Bil	0.6 mg/dL	0.60 mg/dL	0.2–1.3 mg/dL
Glu	101 mg/dL		80–120 mg/dL
BUN	34 mg/dL	31 mg/dL	9.6–22.0 mg/dL
Cre	0.95 mg/dL	1.09 mg/dL	<1.20 mg/dL
Na	129 mEq/L	136 mEq/L	138–145 mEq/L
K	2.6 mEq/L	3.1 mEq/L	3.4–4.7 mEq/L
Cl	93 mEq/L	97 mEq/L	99–108 mEq/L
CRP	0.47 mg/dL	0.44 mg/dL	<0.30 mg/dL
NH^3	131 µg/dL	44 µg/dL	<18 µg/dL
5-FU concentration	13 ng/mL	<10 ng/mL	600 ng/mL (steady state)

Laboratory findings revealed hyperammonemia and mild hyponatremia. Serum concentration of 5-FU was low.