A Case with Transient Hyperammonemia of Newborn

신생아 일과성 고암모니아혈증 1례

  • Lee, Hee-Kyung (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Lee, Beom-Hee (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Jin, Hye-Young (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Kim, Gu-Hwan (Medical Genetics Clinic and Laboratory, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Choi, Jin-Ho (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Yoo, Han-Wook (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine)
  • 이희경 (울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과학교실) ;
  • 이범희 (울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과학교실) ;
  • 진혜영 (울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과학교실) ;
  • 김구환 (울산대학교 의과대학 서울아산병원 소아청소년병원 의학유전학클리닉) ;
  • 최진호 (울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과학교실) ;
  • 유한욱 (울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과학교실)
  • Received : 2010.05.27
  • Accepted : 2010.06.18
  • Published : 2010.03.01

Abstract

Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea Hyperammonemia in the newborn often leads to severe fatal illness associated with hyperammonemic encephalopathy. Transient hyperammonemia in newborns (THAN) is characterized by self-limiting, transient hyperammonemia during the neonatal period. THAN may have favorable long-term outcomes if it is diagnosed early and appropriately managed. However, severe hyperammonemia can develop even in newborns with THAN, which may require emergent management. Here we report a case of THAN with severe hyperammonemia during the neonatal period that was successfully treated with continuous renal replacement therapy and nitrogen-scavenging medications. Our patient went on to develop normally and has not re-experienced a hyperammonemic episode until 9 months of age without the administration of a protein restricted diet or medications.

신생아 시기의 고암모니아혈증은 고암모니아성 뇌병증에 의하여 심각한 뇌기능의 장애를 일으킬 수 있다. 이 중 신생아 일과성 고암모니아혈증 (transient hyperammonemia of newborn, THAN)은 신생아 시기에만 일시적으로 고암모니아 혈증을 보이고, 신생아시기에 적절한 진단과 치료를 통해 양호한 예후를 보이는 질환이다. 그러나 일부에서는 고도의 고암모니아 혈증을 보여 이에 대한 응급치료를 요하기도 한다. 본 증례 보고에서는 신생아 시기에 고암모니아혈증이 발견되어, 신대치요법과 약물치료 후호 전된 1례를 기술하고자 한다. 환아는 이후 생후9개월까지 정상 식이와 약물치료 없이 정상발달을 보이며, 고암모니아혈증의 재발이 없었다.

Keywords

References

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