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Journal of Tropical Pediatrics 1994 40(2):97-99; doi:10.1093/tropej/40.2.97
© 1994 by Oxford University Press
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Hyperammonemia in Marasmic Children

M. R. Morsy, MD, H. Madina, MD, S. A. Sharaf, Phd, A. T. Soliman, MD, M. M Elzalabany, MD and M. A. F. Ramadan, MD

Departments of Pediatrics and Clinical Pathology, University of Alexandria, School of Medicine Loran, Alexandria, Egypt

Correspondence: A. T. Soliman, University of Alexandria, 3 Abd El Sattar Mansour St, Loran, Alexandria, Egypt.

The amino acids citrulline, ornithine and arginine, total serum proteins, serum enzymes glutamic oxalacetic and glutamic pyruvic transaminases, blood ammonia and urea were measured in 20 marasmic children with manifest psycboraotor changes, before and after nutritional rehabilitation, as well as in 10 healthy age-matched children.

Serum protein levels were significantly low and plasma ammonia concentrations were significantly elevated in marasmic children before refeeding (177 ± 66 µg/dl). Plasma ammonia concentrations decreased significantly after 4 weeks of nutritional rehabilitation (38 ±18 µg/dl). Tbe levels of blood urea, serum enzymes, citrulline arginine, and ornithine did not differ among tbe study groups.

These findings denote that hyperammonemia in marasmic children is neither due to defective hepatic function nor due to enzymatic blockade in the urea cycle.


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