Corticosteroid-induced hyperammonaemic encephalopathy in a woman with late-onset ornithine transcarbamylase deficiency

BMJ Case Rep. 2024 May 2;17(5):e255793. doi: 10.1136/bcr-2023-255793.

Abstract

Ornithine transcarbamylase deficiency (OTCD) is a rare, X linked disorder that can manifest in late adulthood in heterozygous females as severe hyperammonaemia following environmental stressors. We present a case of hyperammonaemic encephalopathy that was triggered by glucocorticoid administration in an adult woman with heterozygous OTCD with clinical response to haemodialysis, ammonia scavengers and a high-calorie, low-protein diet.

Keywords: Dialysis; Genetics; Medical management; Unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Brain Diseases / chemically induced
  • Brain Diseases / etiology
  • Diet, Protein-Restricted / adverse effects
  • Female
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use
  • Humans
  • Hyperammonemia* / chemically induced
  • Middle Aged
  • Ornithine Carbamoyltransferase Deficiency Disease* / complications
  • Ornithine Carbamoyltransferase Deficiency Disease* / diagnosis
  • Renal Dialysis

Substances

  • Glucocorticoids