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Surgical Debulking for Refractory Hyperammonemic Encephalopathy in Fibrolamellar Hepatocellular Carcinoma
- Source :
- Hepatology
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- A 26-year-old male with a two-year history of FLC developed progressive somnolence and disorientation. Treatment history for FLC had included cytotoxic chemotherapy, lenvatinib, and immunotherapy. A CT scan confirmed extensive stage FLC with numerous liver, lung, and pelvic metastasis. Laboratory results showed bilirubin 0.3 mg/dL, creatinine 0.4 mg/dl, leukocytes of 9.5x109 /L, hemoglobin 11.2 g/dL, platelets 369x109 /L, and ammonia 247 µmol/L (reference range: 0-32 µmol/L). Plasma amino acid analysis revealed relatively low citrulline (14 µmol/L), arginine (32 µmol/L), and ornithine (35 µmol/L). Urinary orotic acid excretion was markedly elevated at 149 mmol/mol creat (reference range: 0.68-3.52 mmol/mol creat).
- Subjects :
- Adult
Male
Orotic acid
medicine.medical_specialty
Carcinoma, Hepatocellular
Arginine
Bilirubin
Gastroenterology
Article
Excretion
chemistry.chemical_compound
Ammonia
Internal medicine
medicine
Citrulline
Humans
Hyperammonemia
Creatinine
Hepatology
Liver Neoplasms
Cytoreduction Surgical Procedures
Ornithine
medicine.disease
Treatment Outcome
chemistry
Hepatic Encephalopathy
medicine.drug
Subjects
Details
- ISSN :
- 15273350 and 02709139
- Volume :
- 74
- Database :
- OpenAIRE
- Journal :
- Hepatology
- Accession number :
- edsair.doi.dedup.....8b5f733217c2b28f268d2df1154461b9