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Updated: Sep 14, 2026

Determining the Likelihood of Variant Pathogenicity Using Amino Acid-level Signal-to-Noise Analysis of Genetic Variation
Published on: January 16, 2019
Hyperammonemia: a review of etiologies, whole-exome sequencing diagnosis, and Iranian case reports
Reza Hajati1, Sharareh Kamfar2, Reyhaneh Seyfi3
1Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Purpose:
Hyperammonemia is a serious metabolic disturbance characterized by elevated blood ammonia levels that can lead to severe neurological complications. This review aims to provide a comprehensive overview of inherited metabolic disorders associated with hyperammonemia and to evaluate the diagnostic role of whole-exome sequencing (WES), with particular attention to Iranian patient data.
Methods:
A narrative literature search was performed in PubMed/MEDLINE and Google Scholar (1990-2024) using key terms related to hyperammonemia, its inherited etiologies, and whole-exome sequencing.
Results:
Three major categories of inherited disorders associated with hyperammonemia were identified: urea cycle disorders (incidence 1:35,000), organic acidemias (incidence 1:3,600), and fatty acid oxidation deficiencies (incidence 1:9,000). WES has emerged as a powerful diagnostic tool enabling precise genetic diagnosis, as illustrated by several Iranian case reports with novel pathogenic variants.
Conclusion:
Early recognition and accurate genetic diagnosis of hyperammonemia are crucial for optimal patient outcomes. While challenges such as variant interpretation and accessibility remain, the integration of clinical, biochemical, and genetic data, particularly through WES, is essential for effectively diagnosing and managing these disorders.
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