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Hyperammonemia in Marasmic children

M R Morsy1, H Madina, S A Sharaf

  • 1Department of Pediatrics, University of Alexandria, School of Medicine, Loran, Egypt.

Journal of Tropical Pediatrics
|April 1, 1994
PubMed
Summary
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Malnourished children with psychomotor changes had high ammonia levels. Nutritional rehabilitation significantly reduced ammonia, suggesting no liver dysfunction or urea cycle defects in these cases.

Area of Science:

  • Biochemistry
  • Pediatrics
  • Nutrition Science

Background:

  • Malnutrition, specificallymarasmus, is associated with psychomotor changes in children.
  • Elevated plasma ammonia levels have been observed in malnourished individuals, but the underlying cause remains unclear.

Purpose of the Study:

  • To investigate the relationship between malnutrition, psychomotor changes, and ammonia metabolism in children.
  • To determine if hepatic function or urea cycle defects contribute to hyperammonemia in marasmic children.

Main Methods:

  • Measured serum amino acids (citrulline, ornithine, arginine), total proteins, serum enzymes (transaminases), blood ammonia, and urea.
  • Compared levels in 20 marasmic children (before and after nutritional rehabilitation) with 10 healthy controls.

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Main Results:

  • Marasmic children exhibited significantly low serum protein and elevated plasma ammonia before nutritional rehabilitation.
  • Plasma ammonia levels significantly decreased after 4 weeks of nutritional rehabilitation.
  • Blood urea, serum enzymes, and amino acid levels (citrulline, ornithine, arginine) did not differ significantly among groups.

Conclusions:

  • Hyperammonemia in marasmic children is not attributable to impaired hepatic function.
  • The findings suggest that defective urea cycle enzyme activity is not the cause of elevated ammonia in these patients.