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CASE FILES: BIOCHEMISTRY

B IO C H E M IS T R Y PE A R L S

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Ammonia is produced by almost all cells in the body; however, only

the liver has the enzymatic machinery to convert it to urea.

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Liver disease such as cirrhosis affects the ability of the liver to

detoxify ammonia to urea resulting in hyperammonemia.

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Hyperammonemia can be exacerbated by an increase in the ammo-

nia load, such as can occur from gastrointestinal bleeding.

REFERENCES

Coomes MW. Amino acid metabolism. In: Devlin TM, ed. Textbook of

Biochemistry with Clinical Correlations, 5th ed. New York: Wiley-Liss, 2002.

Rodwell VW. Catabolism of proteins & of amino acid nitrogen. In: Murray RK,

Granner DK, Mayes PA, et al. Harper’s Illustrated Biochemistry, 26th ed.

New York: Lange Medical Books/McGraw-Hill, 2003.