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  • Title: [Fulminant coma: think hyperammonemia and urea cycle disorders].
    Author: Augris C, Jouvet P, Benabdelmalek F, Vauquelin P, Caramella JP.
    Journal: Ann Fr Anesth Reanim; 2002 Dec; 21(10):820-3. PubMed ID: 12534125.
    Abstract:
    The authors report the case of 14-year-old boy admitted for acute coma without neurological focal symptom. The only relevant finding was the death of one uncle after a coma in the year 1992. This coma was associated with an ammonia blood level of 344 mumol l-1 and it rapidly lead to cerebral death despite a symptomatic treatment. The diagnosis of hereditary ornithine transcarbamylase deficiency was confirmed by liver biopsy in the immediate post-mortem period. The authors recommend the measurement of blood ammonia in every coma without diagnosis, whatever patient's age.
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