title: Further Concerns About Glutamine: A Case Report on Hyperammonemic Encephalopathy.
abstract: OBJECTIVE
  We report a case of a woman with hyperammonemic encephalopathy following glutamine supplementation.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Plasma amino acid analysis suggestive of a urea cycle defect and initiation of a treatment with lactulose and the two ammonia scavenger drugs sodium benzoate and phenylacetate. Together with a restricted protein intake ammonia and glutamine plasma levels decreased with subsequent improvement of the neurological status.
  
  
  RESULTS
  Massive catabolism and exogenous glutamine administration may have contributed to hyperammonemia and hyperglutaminemia in this patient.
  
  
  CONCLUSIONS
  This case adds further concerns regarding glutamine administration to critically ill patients and implies the importance of monitoring ammonia and glutamine serum levels in such patients.
authors.affiliation: 1Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland. 2Institute of Clinical Chemistry and University Children's Hospital, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland. 3Department of Neurology, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland.
authors.forename: Luca
authors.initials: L
authors.lastname: Cioccari
authors.forename: Matthias
authors.initials: M
authors.lastname: Gautschi
authors.forename: Reto
authors.initials: R
authors.lastname: Etter
authors.forename: Anja
authors.initials: A
authors.lastname: Weck
authors.forename: Jukka
authors.initials: J
authors.lastname: Takala
mesh_terms: D001928:Brain Diseases, Metabolic / Q000139:chemically induced*; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D005973:Glutamine / Q000009:adverse effects*; D006801:Humans; D022124:Hyperammonemia / Q000139:chemically induced*; D008875:Middle Aged
chemical_list: D005973:Glutamine