Reversibility of serum NH3 level in a case of sudden onset and rapidly progressive case of type 2 citrullinemia

Fumihiko Ishikawa, Makoto Nakamuta, Masaki Kato, Hiroaki Iwamoto, Munechika Enjoji, Yasuji Miyata, Toyoshi Inoguchi, Hironori Sakai, Hajime Nawata

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12 Citations (Scopus)


A 48-year-old male presented with an acute change in mental status due to a marked elevation of plasma NH3 and was diagnosed with citrullinemia with amino acid analysis of blood. Hemodialysis and hemodiafiltration were performed, but serum chemical analysis did not show any improvement which led us to terminate dialysis following intensive care for 3 days. Surprisingly, NH3 level had decreased by 6 days after admission, coinciding with normalization of the size of the pupils. Since spontaneous remission had never been discussed, we discuss this relatively rare, but clinically significant entity with regard to its acute phase management and its potential reversibility.

Original languageEnglish
Pages (from-to)925-929
Number of pages5
JournalInternal Medicine
Issue number11
Publication statusPublished - Nov 2000

All Science Journal Classification (ASJC) codes

  • Internal Medicine


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