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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 146 (1998), S. 652-658 
    ISSN: 1433-0474
    Keywords: Schlüsselwörter OTC ; Harnstoffzyklus ; Hyperammonämien ; Heterozygotentest ; Key words OTC ; Urea cycle ; Hyperammonemia ; Heterozygotes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Ornithine transcarbamylase deficiency is the most frequent inborn error of metabolism of the urea cycle which causes severe hyperammonemia in hemizygous boys within the first days of life. However, also girls heterozygous for this x-linked disorder can develop life-threatening hyperammonemia and chronic progressive encephalopathy. This paper describes the emergency treatment of first manifestations including all necessary diagnostic measures as well as the longterm therapy and its control. Enclosed are the details about the allopurinol challenge test for the detection of heterozygous women and girls.
    Notes: Zusammenfassung Der Ornithintranscarbamylasemangel ist der häufigste angeborene Defekt des Harnstoffzyklus. Er wird im Gegensatz zu anderen akut verlaufenden angeborenen Stoffwechselerkrankungen X-chromosomal vererbt. Betroffene Jungen zeigen in der Regel schon in den ersten Lebenstagen infolge einer sich ausbildenden Hyperammonämie schwere klinische Symptome wie zunehmende Lethargie, Erbrechen, Krampfanfälle und Koma. Aber auch Überträgerinnen können lebensbedrohliche Hyperammonämien sowie progrediente chronische Enzephalopathiesyndrome entwickeln. Die Notfallbehandlung bei der Erstmanifestation inklusive aller diagnostischer/differentialdiagnostischer Maßnahmen sowie die Langzeittherapie und Stoffwechselüberwachung dieser Patienten sind in der vorliegenden Arbeit beschrieben. Zusätzlich wird über den Allopurinoltest berichtet, der zur Erfassung Heterozygoter verwendet wird.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 127 (1978), S. 75-89 
    ISSN: 1432-1076
    Keywords: Hyperinsulinism ; β-cell hyperplasia ; Nesidioblastosis ; Newborn ; Infants ; Somatostatin ; Electron microscopy ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two patients with severe hypoglycemia since birth are described. In both hyperinsulinism was demonstrated during spontaneous hypoglycemic attacks or could be provoked by various tolerance tests. In case I considerable obesity and psychomotor retardation was present at the age of one year whereas in case II weight gain was normal and development unaffected. Immunofluorescence microscopic and electron microscopic examination of the pancreas after subtotal pancreatectomy revealed diffuse islet cell hyperplasia with nesidioblastosis in case I and β-cell nesidioblastosis in case II. The hyperplastic and nesidioblastotic areas consisted mainly of β-cells. In addition, an accumulation of somatostatin producing cells was observed in case I, and some cells were found with ultrastructural signs of both endocrine and exocrine function. In both cases, pancreatic insulin release was inhibited by a prolonged somatostatin infusion. The results of tolerance tests did not allow a diagnosis of the underlying pancreatic lesion. In case II, leucine-sensitive hypoglycemia detected soon after birth, was present even after subtotal pancreatic resection. Therapeutic trials with diazoxide in case I and a leucine-restricted diet in case II were only of temporary benefit. After subtotal pancreatectomy there was clinical improvement in both cases, but case II still needs a leucine-restricted diet. The familial occurrence of persistent hypoglycemia in both cases suggests that β-cell nesidioblastosis may be a hereditary disorder.
    Type of Medium: Electronic Resource
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