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Updated: Apr 12, 2026

Executing Complexity-Increasing Queries in Relational MySQL and NoSQL MongoDB and EXist Size-Growing ISO/EN 13606 Standardized EHR Databases
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Coma query cause.

Georgina Elizabeth Wood1, James McNicholas1

  • 1Intensive Care Unit, Queen Alexandra Hospital, Portsmouth, Hampshire, UK.

BMJ Case Reports
|May 8, 2015
PubMed
Summary
This summary is machine-generated.

A woman with coeliac disease developed hyperammonemic coma due to ornithine transcarbamylase deficiency, a rare adult urea cycle disorder, during refeeding. Management challenges are discussed.

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Area of Science:

  • Biochemistry
  • Metabolic Disorders
  • Clinical Medicine

Background:

  • Coeliac disease requires nutritional support, often involving protein intake.
  • Refeeding syndrome can precipitate metabolic complications in malnourished patients.
  • Urea cycle disorders are typically diagnosed in childhood but can present in adults.

Observation:

  • A 54-year-old woman with coeliac disease experienced rapid deterioration after initiating supplemental nutrition.
  • The patient presented with hyperammonemic coma, a critical complication of refeeding syndrome.
  • Extensive intensive care was required for stabilization and management.

Findings:

  • Biochemical investigations confirmed a diagnosis of ornithine transcarbamylase deficiency.
  • This represents a rare adult-onset presentation of a urea cycle disorder.
  • The case highlights the interplay between coeliac disease, refeeding, and metabolic dysfunction.

Implications:

  • Adult-onset urea cycle disorders, like ornithine transcarbamylase deficiency, should be considered in unexplained hyperammonemia.
  • Careful nutritional management is crucial in patients with coeliac disease to prevent refeeding complications.
  • This case underscores the importance of understanding protein metabolism and urea cycle function in critical care settings.