Hyperammonemia-induced encephalopathy: A rare devastating complication of bariatric surgery

Table 1 Laboratory investigations and imaging at time of hospitalization

Laboratory investigation/imaging	Values
BMP	Within normal limits (Cr 1.0 mg/dL)
CBC	Within normal limits (platelets 158 K/μL)
Iron panel	Within normal limits
Hepatic panel	AST 30 U/L
	ALT 9 U/L
	Alkaline phosphatase 52 U/L
	Total Bilirubin 0.9 mg/dL
Urine orotic acid	1.4 mmol/mol of creatinine
Ammonia level	155 mcg/dL
Carnitine level, zinc, manganese, vitamin B12, vitamin A, vitamin D	Within normal limits
Abdominal ultrasound	No evidence of liver disease or cirrhosis
MRI brain	No acute or chronic intracranial abnormalities

MRI: Magnetic resonance imaging; BMP: Basic metabolic panel; CBC: Complete blood count; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase.