Hyperammonemia in a carbamoyl-phosphate synthetase 1 deficiency recipient after living-donor liver transplantation from a carrier donor: a case report

Carbamoyl-phosphate synthetase 1 (CPS1) deficiency is an autosomal recessive congenital urea cycle disorder (UCD) characterized by hyperammonemia. The recipients of liver transplantation (LT) for UCD are often children, and the potential donors are often the parents. Hereditary congenital diseases i...

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Main Authors: Toshihiko Kakiuchi, Tetsuya Nosho, Masafumi Oka, Katsuya Tashiro
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-01-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2023.1327854/full
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author Toshihiko Kakiuchi
Tetsuya Nosho
Masafumi Oka
Katsuya Tashiro
author_facet Toshihiko Kakiuchi
Tetsuya Nosho
Masafumi Oka
Katsuya Tashiro
author_sort Toshihiko Kakiuchi
collection DOAJ
description Carbamoyl-phosphate synthetase 1 (CPS1) deficiency is an autosomal recessive congenital urea cycle disorder (UCD) characterized by hyperammonemia. The recipients of liver transplantation (LT) for UCD are often children, and the potential donors are often the parents. Hereditary congenital diseases involving UCD entail the possibility of both parents being genetically heterozygous. Herein, we describe the case of a 12-year-old girl with CPS1 deficiency receiving a liver transplant (soon after birth) from her father, who had a heterozygous CPS1 mutation. She was referred to our hospital with respiratory distress after contracting two infections (respiratory syncytial virus and human metapneumovirus) within a short period, both of which presented with hyperammonemia. Medication for hyperammonemia quickly lowered the ammonia levels. The hyperammonemia was thought to be caused by the heterozygous mutation in the donor liver; moreover, it is likely that the low enzyme activity in the patient’s liver was increased due to the infections. This is the first study to report hyperammonemia in a CPS1 deficiency patient due to an infection after LT. Thus, patients with CPS1 deficiency should be aware of the development of hyperammonemia after LT.
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spelling doaj.art-abfd4e0525994788a5055140043d8a572024-01-03T04:19:57ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-01-011010.3389/fmed.2023.13278541327854Hyperammonemia in a carbamoyl-phosphate synthetase 1 deficiency recipient after living-donor liver transplantation from a carrier donor: a case reportToshihiko Kakiuchi0Tetsuya Nosho1Masafumi Oka2Katsuya Tashiro3Department of Pediatrics, Faculty of Medicine, Saga University, Saga, JapanDepartment of Pediatrics, Faculty of Medicine, Saga University, Saga, JapanDepartment of Pediatrics, Faculty of Medicine, Saga University, Saga, JapanDepartment of Pediatrics, Karatsu Red Cross Hospital, Karatsu, JapanCarbamoyl-phosphate synthetase 1 (CPS1) deficiency is an autosomal recessive congenital urea cycle disorder (UCD) characterized by hyperammonemia. The recipients of liver transplantation (LT) for UCD are often children, and the potential donors are often the parents. Hereditary congenital diseases involving UCD entail the possibility of both parents being genetically heterozygous. Herein, we describe the case of a 12-year-old girl with CPS1 deficiency receiving a liver transplant (soon after birth) from her father, who had a heterozygous CPS1 mutation. She was referred to our hospital with respiratory distress after contracting two infections (respiratory syncytial virus and human metapneumovirus) within a short period, both of which presented with hyperammonemia. Medication for hyperammonemia quickly lowered the ammonia levels. The hyperammonemia was thought to be caused by the heterozygous mutation in the donor liver; moreover, it is likely that the low enzyme activity in the patient’s liver was increased due to the infections. This is the first study to report hyperammonemia in a CPS1 deficiency patient due to an infection after LT. Thus, patients with CPS1 deficiency should be aware of the development of hyperammonemia after LT.https://www.frontiersin.org/articles/10.3389/fmed.2023.1327854/fullcarbamoyl-phosphate synthetase 1 deficiency diseasehyperammonemialiver transplantationornithine transcarbamylase deficiency diseaseheterozygous
spellingShingle Toshihiko Kakiuchi
Tetsuya Nosho
Masafumi Oka
Katsuya Tashiro
Hyperammonemia in a carbamoyl-phosphate synthetase 1 deficiency recipient after living-donor liver transplantation from a carrier donor: a case report
Frontiers in Medicine
carbamoyl-phosphate synthetase 1 deficiency disease
hyperammonemia
liver transplantation
ornithine transcarbamylase deficiency disease
heterozygous
title Hyperammonemia in a carbamoyl-phosphate synthetase 1 deficiency recipient after living-donor liver transplantation from a carrier donor: a case report
title_full Hyperammonemia in a carbamoyl-phosphate synthetase 1 deficiency recipient after living-donor liver transplantation from a carrier donor: a case report
title_fullStr Hyperammonemia in a carbamoyl-phosphate synthetase 1 deficiency recipient after living-donor liver transplantation from a carrier donor: a case report
title_full_unstemmed Hyperammonemia in a carbamoyl-phosphate synthetase 1 deficiency recipient after living-donor liver transplantation from a carrier donor: a case report
title_short Hyperammonemia in a carbamoyl-phosphate synthetase 1 deficiency recipient after living-donor liver transplantation from a carrier donor: a case report
title_sort hyperammonemia in a carbamoyl phosphate synthetase 1 deficiency recipient after living donor liver transplantation from a carrier donor a case report
topic carbamoyl-phosphate synthetase 1 deficiency disease
hyperammonemia
liver transplantation
ornithine transcarbamylase deficiency disease
heterozygous
url https://www.frontiersin.org/articles/10.3389/fmed.2023.1327854/full
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