HYPERAMMONEMIA IN MARASMIC CHILDREN

The amino acids citrulline, ornithine and arginine, total serum protei ns, serum enzymes glutamic oxalacetic and glutamic pyruvic transaminas es, blood ammonia and urea were measured in 20 marasmic children with manifest psychomotor changes, before and after nutritional rehabilitat ion, as well as in 10 healthy age-matched children. Serum protein leve ls were significantly low and plasma ammonia concentrations were signi ficantly elevated in marasmic children before refeeding (177+/-66 mu g /dl). Plasma ammonia concentrations decreased significantly after 4 we eks of nutritional rehabilitation (38+/-18 mu g/dl). The levels of blo od urea, serum enzymes, citrulline arginine, and ornithine did not dif fer among the study groups. These findings denote that hyperammonemia in marasmic children is neither due to defective hepatic function nor due to enzymatic blockade in the urea cycle.