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Arginine Deficiency‐Induced Hyperammonemia in a Home Total Parenteral Nutrition‐Dependent Patient: A Case Report
Author(s) -
Kapila Shikha,
Saba May,
Lin ChuanHao,
Bawle Erawati V.
Publication year - 2001
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607101025005286
Subject(s) - hyperammonemia , short bowel syndrome , parenteral nutrition , arginine , medicine , encephalopathy , gastroenterology , hemodialysis , enteral administration , intensive care medicine , pediatrics , amino acid , biochemistry , chemistry
Background: Patients with short bowel syndrome and renal dysfunction with TPN dependence are at high risk for developing hyperammonemia if the TPN does not contain sufficient quantities of arginine. Providing proper nutrition support is essential in the management of these patients. Methods: We report on a patient with short bowel syndrome, TPN dependence, and normal renal function who developed hyperammonemic encephalopathy due to inadvertent lack of arginine in his TPN. Results: The patient was successfully treated with hemodialysis and an IV arginine infusion to resolve the hyperammonemia. His home TPN was also adjusted such that arginine was added to his subsequent solutions. Conclusions: Our patient underscores the importance of adequate and sustained arginine supplementation to avoid hyperammonemia in TPN dependent patients with short bowel syndrome. ( Journal of Parenteral and Enteral Nutrition 25 :286–288, 2001)