Abstract
Idiopathic hyperammonemia is a rare, poorly understood, and often lethal condition that has been described in immunocompromised patients. This report describes an immunocompromised patient with acute myelogenous leukemia who developed persistent hyperammonemia up to 705 µmol/L (normal, 0 to 47 µmol/L) refractory to multiple different therapies. However, after beginning azithromycin and then doxycycline therapy for Ureaplasma species infection, the patient showed immediate and sustained clinical improvement and resolution of ammonia levels. Recognizing disseminated Ureaplasma species infection as a potential cause of idiopathic hyperammonemia, an unexplained, often fatal condition in immunocompromised patients, and empirically treating for this infection could potentially be lifesaving.
References
Nov 1, 1988·The American Journal of Medicine·R B MitchellR Saral
Jun 1, 1993·Journal of Bacteriology·D G SmithD Thirkell
Aug 1, 1997·Acta Paediatrica·C RennerA Schless
Mar 3, 1999·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·J O ClemmesenP Ott
Apr 18, 2001·The Oncologist·P D King, M C Perry
Dec 10, 2008·Clinical Lymphoma & Myeloma·Jaime Lora-TamayoRamón Pujol
Sep 16, 2014·Journal of Pediatric Hematology/oncology·Shogo KobayashiAtsushi Kikuta
Jan 13, 2015·Journal of Clinical Anesthesia·Roy K Kiberenge, Humphrey Lam
Feb 3, 2015·Molecular Genetics and Metabolism·Alexander LaemmleJohannes Häberle
Apr 24, 2015·Science Translational Medicine·Ankit BharatRobin Patel
Sep 4, 2015·Transplantation·Catherine ChenChad A Witt
Oct 3, 2015·Journal of Clinical Anesthesia·Michael L Beeton
Aug 19, 2016·PloS One·Xiaohui WangRobin Patel
Nov 1, 2016·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·X WangR Patel
Feb 24, 2017·Rinshō shinkeigaku = Clinical neurology·Toshiaki GodaDaisuke Takahashi
Mar 16, 2017·Clinical Transplantation·Dustin KrutsingerMichael Eberlein
May 26, 2017·BMJ Case Reports·Abubaker A I HassanAbdelaziz Mohamed
Jan 24, 2018·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Riley GraetzEmmanuel Katsanis
Citations
Jan 2, 2021·Journal of Microbiological Methods·Derek FlemingRobin Patel
Nov 17, 2020·Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine·Robert F LegerKsenia D Guvakova
Oct 18, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Scott C RobertsMichael G Ison
May 6, 2021·Clinical Transplantation·Ourlad Alzeus G TantengcoCybele Lara R Abad