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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.