• BMJ case reports · May 2015

    Case Reports

    Coma query cause.

    • Georgina Elizabeth Wood and James McNicholas.
    • Intensive Care Unit, Queen Alexandra Hospital, Portsmouth, Hampshire, UK.
    • BMJ Case Rep. 2015 May 6; 2015.

    AbstractA 54-year-old woman with coeliac disease was admitted to hospital electively for supplemental nutrition. Shortly after feeding started she deteriorated into a hyperammonemic coma with refeeding syndrome, requiring an extensive intensive care admission. Urea cycle disorders were investigated and a biochemical diagnosis of ornithine transcarbamylase deficiency was made. This is a rare diagnosis in the adult population. This case report summarises protein metabolism, urea cycle disorders and the challenges of management. 2015 BMJ Publishing Group Ltd.

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