• Luca Cioccari, Matthias Gautschi, Reto Etter, Anja Weck, and Jukka Takala.
• 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.
• Crit. Care Med. 2015 Oct 1;43(10):e458-60.

ObjectiveWe report a case of a woman with hyperammonemic encephalopathy following glutamine supplementation.DesignCase report.InterventionsPlasma 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.Measurements And Main ResultsMassive catabolism and exogenous glutamine administration may have contributed to hyperammonemia and hyperglutaminemia in this patient.ConclusionThis 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.

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