FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 299:920-925 October 26, 1978 Number 17 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We report on five preterm infants (34 to 36 weeks' gestation) in whom an overwhelming illness developed within the first 48 hours of life. Each had mild respiratory distress that progressed within 48 hours to deep coma requiring ventilatory assistance. Ammonia concentrations in the plasma ranged from 844 to 7640 microgram per deciliter. Four received exchange transfusion and peritoneal dialysis; ammonia values returned to the normal range (less than 150 mug per deciliter) within 72 hours and remained there even after protein challenge. These four subsequently fed and developed normally. The fifth infant died without an attempt to lower plasma ammonia. In this infant (and two of the others) urea-cycle enzymes measured in liver tissue were in the normal range. Transient hyperammonemia of unknown cause may be a relatively common variety of neonatal hyperammonemia; it responds well to prompt diagnosis and aggressive therapy.

This article has been cited by other articles:

• Burton, B. K. (1998). Inborn Errors of Metabolism in Infancy: A Guide to Diagnosis. Pediatrics 102 : e69-e69 [Abstract] [Full Text]  
• Trauner, D. A., Self, T. W. (1984). Detection of Urea Cycle Enzymopathies in Childhood. Arch Neurol 41: 758-760 [Abstract]  
• Shohat, M., Wielunsky, E., Reisner, S.H. (1984). Plasma Ammonia Levels in Preterm Infants Receiving Parenteral Nutrition with Crystalline L-Amino Acids. JPEN J Parenter Enteral Nutr 8: 178-180 [Abstract]