European Journal of Pediatrics

, Volume 162, Issue 11, pp 773–775 | Cite as

Hyperammonaemia as a cause of psychosis in an adolescent

  • Amaya Bélanger-Quintana
  • Mercedes Martínez-Pardo
  • María José García
  • Bendicht Wermuth
  • Julián Torres
  • Esperanza Pallarés
  • Magdalena Ugarte
Original Paper


Diseases that cause hyperammonaemia usually appear during the neonatal period or during the first months of life as severe neurological metabolic distress. In some cases, as the one reported here, the age of onset and initial symptoms are non-specific and the episodes of acute metabolic encephalopathy may be attributed to encephalitis, poisoning or psychiatric problems. Our patient had N-acetyl glutamate synthetase deficiency due to a lack of activation by L-arginine. Treatment with N-carbamylglutamate was successful in maintaining normal ammonia levels. Conclusion: we emphasise the importance of measuring ammonia levels in patients with neurological or psychiatric symptoms as part of their diagnostic work-up.


Adolescent Hyperammonaemia N-acetylglutamate synthetase deficiency N-carbamylglutamate Psychosis 



carbamoyl phosphate synthetase




N-acetylglutamate synthetase




ornithine transcarbamylase


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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Amaya Bélanger-Quintana
    • 1
  • Mercedes Martínez-Pardo
    • 1
  • María José García
    • 2
  • Bendicht Wermuth
    • 3
  • Julián Torres
    • 4
  • Esperanza Pallarés
    • 1
  • Magdalena Ugarte
    • 2
  1. 1.Unidad de Enfermedades MetabólicasServicio de Pediatría, Hospital Ramón y CajalMadridSpain
  2. 2.Centro de Diagnostico of Enfemedades MolecularesUniversidad Autónoma de MadridMadridSpain
  3. 3.Department of Clinical ChemistryInselspitalBerneSwitzerland
  4. 4.Departamento de NeuropediatríaHospital de MóstolesMadridSpain

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