So ammonia dɔɔso dodo wɔ wo mogya mu? Momma yensua tebea a asiane wom a ɛwɔ hyperammonemia mu no ho ade!

Nneɛma pii rekɔ so wɔ yɛn nipadua mu, ɛnte saa? Ɛtɔ mmere bi a, sɛ saa nneɛma yi kɔ yiye kakra a, ɔhaw akɛse betumi asɔre. Sɛ nhwɛso no, hyperammonemia yɛ tebea a emu yɛ den a ɛba bere a nwura bi a wɔfrɛ no ammonia kɔ soro wɔ yɛn mogya mu no. Ɛho hia paa sɛ wuhu eyi efisɛ sɛ woanhwɛ so yiye a, ebetumi anya w’asetra so nkɛntɛnso kɛse.

Dɛn ne Hyperammonemia?

Sɛ yɛbɛka no tiawa a, hyperammonemia yɛ bere a wo mogya mu ammonia dodow kɔ soro wɔ ɔkwan a ɛnteɛ so. Ammonia, anaa NH3, yɛ nwura a ɛba yɛn dwensɔtwaa mu bere a yɛyam protein a yedi no. Mpɛn pii no, saa ammonia yi kɔ yɛn mmerɛbo mu na wɔyɛ ho adwuma wɔ hɔ. Yɛfrɛ saa adeyɛ yi urea kyinhyia . Ɛdenam saa kyinhyia yi so no, ammonia dan ade a ɛnyɛ nea epira kɛse a wɔfrɛ no urea na ɛkɔ nsu mu. Nanso, sɛ biribi ankɔ yiye wɔ urea kyinhyia yi mu, anaasɛ mmerɛbo no ntumi nyɛ ammonia yi ho adwuma yiye a, ammonia fi ase boaboa ano wɔ mogya no mu. Ammonia a ɛkɔ soro wɔ mogya mu yi yɛ awuduru kɛse ma yɛn Central Nervous System (CNS) , a ɛyɛ amemene ne akyi berɛmo no. Ɛno nti na hyperammonemia yɛ tebea a ɛhwehwɛ sɛ wɔkɔ ayaresabea ntɛm ara na ebetumi de nkwa mpo ato asiane mu no .

Hena na obetumi anya eyi kɛse?

Saa tebea yi a wɔfrɛ no hyperammonemia no betumi aka mmofra a wɔawo wɔn foforo, mmofra nkumaa, ne mpanyimfo.

• Wɔ mpanyimfo mu no, wɔn a wɔwɔ saa tebea yi mu bɛyɛ 90% ne wɔn a wɔwɔ mmerɛbo mu yare .
• Nkokoaa a wɔawo wɔn foforo betumi anya eyi efisɛ wɔwo wɔn a wɔwɔ sintɔ bi wɔ urea kyinhyia mu (congenital urea cycle disorder) . Eyinom yɛ awosu mu tebea horow.
• Afei nso, mmerɛbo a entumi nyɛ adwuma yiye ne nyarewa a wonya fi awo mu a ɛma nipadua no yɛ adwuma no betumi ama mmofra nkumaa anya hyperammonemia.

Ɛyɛ den sɛ yɛbɛka sɛnea eyi abu so ankasa, efisɛ ebetumi afi nneɛma ahorow mu aba. Nanso nhwehwɛmufo bu akontaa sɛ urea kyinhyia mu ɔhaw ahorow, nea ɛde ba no mu biako, ka nkokoaa 250,000 biara a wɔwo wɔn wɔ United States no mu biako ne nkokoaa 440,000 biara mu biako a wɔwo wɔn wɔ amanaman ntam.

Dɛn ne nneɛma a ɛde hyperammonemia ba?

Nneɛma pii betumi ama eyi aba. Saa ntease ahorow yi betumi asesa bere a obi nyin no. Nanso mpɛn pii no, nneɛma atitiriw abien a ɛde ba ne mmerɛbo mu haw ne urea kyinhyia mu ɔhaw ahorow (UCDs) .

Esiane mmerɛbo mu haw ahorow nti

Yɛn mmerɛbo ne akwaa titiriw a ɛdannan ammonia ma ɛbɛyɛ urea. Enti sɛ mmerɛbo no asɛe anaa yare a, entumi nyɛ ammonia ho adwuma yiye. Eyi ne bere a ammonia boaboa ano wɔ mogya no mu. Tebea ahorow bi a ɛfa mmerɛbo ho a ebetumi ama obi anya hyperammonemia ni:

• Berɛbo mu yare : Sɛ mmerɛbo no sɛe a , tumi a etumi yɛ ammonia ho adwuma no sua. Eyi taa ba mmerɛbo mu yare a emu yɛ den mu, nanso wɔ nnipa a wɔwɔ mmerɛbo mu yare a ɛyɛ den mpo mu no, ɛtɔ mmere bi a ammonia dodow betumi akɔ soro mpofirim, sɛ nhwɛso no, sɛ biribi si wɔ yafunu anaa dwensɔtwaa mu (yafunu mu mogya ) anaasɛ sɛ anyinam ahoɔden a ɛnkari pɛ a Eyi ne ade titiriw a ɛma ammonia dodow kɔ soro wɔ mpanyimfo ne mmofra mu.
• Hepatic encephalopathy : Eyi ba bere a mmerɛbo no asɛe na entumi nyɛ ammonia ho adwuma yiye no. Ammonia boaboa ano wɔ mogya no mu na ɛkɔ amemene no mu. Eyi betumi ama adwene atu afra, adwene atu afra , na akɔ koma mu mpo. Ɛtɔ mmere bi a, ebetumi akum obi.
• Mberɛbo mu yare: Mmere mu yare yɛ mmerɛbo mu ntini a ɛte apɔw a wɔde akuru ntini si ananmu. Eyi betumi ama mmerɛbo no anyɛ adwuma yiye na ebetumi ama obi anya hyperammonemia. Cirrhosis yɛ mmerɛbo mu yare a enni sabea.
• mmerɛbo a entumi nyɛ adwuma yiye: Eyi ne bere a mmerɛbo no gyae adwumayɛ mpofirim. Ebetumi afi nyarewa ne tebea ahorow mu aba. Sɛ nhwɛso no, mmerɛbo mu opira a nnuru de ba a nnuru bi te sɛ acetaminophen , de ba no yɛ mmerɛbo a entumi nyɛ adwuma yiye wɔ United States nyinaa mu 50%. Ɛyɛ hyperammonemia a ɛba mmofra mu no mu 64%.
• Mogya a ɛkɔ wo mmerɛbo mu a ɛso tew: Sɛ mogya ankɔ wo mmerɛbo mu yiye a, nipadua no ntumi mfa ammonia nkɔ mmerɛbo no mu nkɔyɛ ho adwuma. Ɛno mpo no, ammonia boaboa ano wɔ mogya no mu.
• Reye yare no:Eyi yɛ tebea a ɛntaa nsi koraa. Ɛka mogya, amemene, ne mmerɛbo. Mpɛn pii no ɛma mogya mu ammonia dodow kɔ soro na ɛma mogya mu glucose dodow so tew. Ɛtaa ka mmofra nkumaa ne mmabun a wɔrenya ahoɔden afi ɔyare mmoawa te sɛ akisikuru anaa atiridii/influensa mu na wɔanom aspirin ama saa sɛnkyerɛnne ahorow no. Wonnim nea ɛde Reye yare no ba ankasa. Nanso, esiane asiane yi nti, ɛnsɛ sɛ wɔde aspirin ma mmofra nkumaa ne mmabun gye sɛ oduruyɛfo kamfo kyerɛ wɔn pɔtee.

Esiane Urea Kyinhyia Ho Nsɛnnennen (UCDs) nti .

Sɛnea yɛadi kan aka ho asɛm no, urea kyinhyia no ne ɔkwan a wɔfa so dan ammonia a awuduru wom ma ɛbɛyɛ urea na wɔayi afi nsu mu. Saa kyinhyia yi wɔ anammɔn pii, na emu biara hwehwɛ sɛ wɔde enzyme soronko bi di dwuma. Saa enzyme ahorow yi ne:

• N-acetyl-glutamate synthase (NAGS) a ɛyɛ adwuma wɔ ɔkwan a ɛyɛ nwonwa so.
• Carbamoyl phosphate a wɔde yɛ nneɛma (CPS) .
• Ornithine transcarbamylase (OTC) a wɔde di dwuma wɔ ɔkwan a ɛyɛ hu so .
• Argininosuccinate a wɔde yɛ nnuru (AS) .
• Argininosuccinic acid lyase (ASL) a ɛyɛ aduru a ɛma obi nya akisikuru .
• Arginase (ARG1) a ɛwɔ nipadua no mu.

Sɛ enzyme ahorow yi mu biako nni hɔ a, urea kyinhyia no ntumi nyɛ adwuma yiye. Ammonia boaboa ano wɔ mogya no mu. Wɔfrɛ saa enzyme a enni nipadua no mu yi sɛ urea cycle disorder (UCD). UCD betumi ama hyperammonemia aba, na ebetumi ayɛ nea emu yɛ den anaasɛ enni sabea. UCDs yɛ tebea horow a wɔde awo obi. Mpɛn pii no, mmofra a wɔawo wɔn foforo a urea cycle enzyme bi nni wɔn koraa no nya hyperammonemia a emu yɛ den wɔ nnɔnhwerew 24 kosi 72 akyi wɔ awo akyi. Sɛ́ ebia enzyme a enni nipadua no mu no nyɛ den anaasɛ ɛyɛ fã bi no, ammonia a ɛbɛboaboa ano no betumi aba bere biara wɔ asetra mu, bere a ɔyare, adwennwen, anaa nsɛm afoforo a ɛhaw adwene asi. Saa UCD ahorow yi na ɛma mmofra nkumaa a wɔyare denneennen no mu 23%.

Nneɛma afoforo nti

Sɛ eyi da nkyɛn a, ebia ntease afoforo pii wɔ hɔ:

• Asaabo (asaabo) a entumi nyɛ adwuma yiye: Sɛ asaabo no ntumi nyi urea mfi mu yiye esiane asaabo a entumi nyɛ adwuma nti a, ebetumi ama ammonia aboaboa ano wɔ mogya no mu.
• Mogya mu haw ahorow bi: Hyperammonemia nso betumi afi mogya mu nyarewa te sɛ multiple myeloma ne acute leukemia mu.
• Nyarewa bi: mmoawa a wɔyɛ urease te sɛ Proteus mirabilis , Escherichia coli (E. coli) ne KlebsiellaMmoawa a wɔde nyarewa ba te sɛ streptococci, titiriw wɔ mmofra a wɔwoo wɔn wɔ wɔn awo mu ne mpanyimfo a wɔn mfe akɔ anim a wɔn nsu ntumi nkɔ wɔn mu esiane nsu mu yare (UTIs) nti no betumi ama hyperammonemia a emu yɛ den aba.

Dɛn ne Hyperammonemia ho sɛnkyerɛnne ahorow?

Nsɛnkyerɛnne no betumi ayɛ soronko kɛse a egyina sɛnea tebea no mu nyɛ den anaasɛ emu yɛ den, ne mfe a obi adi so.

Nsɛnkyerɛnne a emu nyɛ den a ɛtaa ba mmofra ne mpanyimfo so

• Akisikuru ne ɔfe
• Yafunu mu yaw
• Abufuw a wɔtaa yɛ
• Tiyɛ (tiyɛ) .
• Ɛyɛ den sɛ wobɛkari pɛ, ayɛ biako, na woakasa (ataxia) .
• Suban mu nsakrae

Nsɛnkyerɛnne foforo a emu nyɛ den a ɛka mmofra nkutoo

• Nkɔso a entumi nyɛ yiye
• Ntini mu mmerɛwyɛ (hypotonia) .
• Ntini mu nkɔso a ɛkyɛ

Nsɛnkyerɛnne a emu yɛ den wɔ mmofra ne mpanyimfo mu

Eyinom yɛ sɛnkyerɛnne ahorow a asiane wom kɛse. Sɛ wowɔ eyinom mu bi a, ɛsɛ sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara.

• Adwene a ɛyɛ basaa ne adwene a ɛyɛ basaa
• Adwene mu nsakrae
• Dae a ɛma obi da dodo
• Nsakrae a ɛba n’adwene mu
• Akisikuru a ɛma obi ho kyere no
• Ɔhome a wɔhome ntɛmntɛm (Hyperventilation) .
• Coma

Kɔkɔbɔ: Sɛ wo anaa obi a ɔbɛn wo wɔ saa sɛnkyerɛnne yi a, yɛsrɛ wo frɛ 911 ntɛm ara, anaa kɔ ayaresabea a ɛbɛn wo no dwumadibea a wɔhwɛ ntɛmpɛ so. Ammonia dodow a ɛkɔ soro wɔ mogya mu no de nkwa to asiane mu na ehia sɛ wɔkɔ ayaresabea ntɛm ara!

Nsɛnkyerɛnne a ɛwɔ nkokoaa a wɔawo wɔn foforo mu

Sɛ hyperammonemia nya akokoaa a wɔawo no foforo a, mpɛn pii no, sɛnkyerɛnne ahorow a edidi so yi da adi wɔ nnɔnhwerew 24 kosi 72 akyi wɔ awo akyi:

• Abufuw a wɔtaa yɛ, su a wɔtaa su
• Ɔfe a wɔfe
• Ɔbrɛ
• Akisikuru a ɛma obi ho kyere no
• Grunting bere a worehome no
• Ɔhome a wɔhome ntɛmntɛm (Hyperventilation) .

Nea ɛho hia: Sɛ wo ba no da saa sɛnkyerɛnne ahorow yi adi a, sɛ woda so ara wɔ ayaresabea a, frɛ oduruyɛfo no ntɛm ara. Sɛ wowɔ fie a, frɛ 911 ntɛm ara, anaa fa wɔn kɔ ayaresabea a ɛbɛn wo. Eyi nyɛ biribi a ɛsɛ sɛ wɔtwentwɛn so.

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Nnuruyɛfo taa susuw sɛ hyperammonemia denam ammonia dodow a ɛwɔ mogya no mu a wɔsɔ hwɛ so.

• Wɔ nkokoaa a wɔadi kosi ɔsram biako fam no, sɛ ammonia dodow a ɛwɔ mogya no mu boro micromol 80/lita (80 micromol/L) a.
• Wɔ mmofra a wɔanyinyin fam no, sɛ ɛboro 55 micromol/lita (55 micromol/L) a.
• Wɔ mpanyimfo mu no, sɛ ɛboro micromol 30/lita (30 micromol/L) a.

Saa ade a wɔde susuw ade yi (micromol/L) yɛ ɔkwan a wɔfa so susuw ammonia dodow a ɛwɔ mogya no mu.

Sɔhwɛ ahorow bɛn na wɔyɛ de hu eyi?

The main test is a blood test that measures the level of ammonia in your blood. Sɛ wo ammonia dodow dɔɔso a, ebia wo duruyɛfo bɛyɛ nhwehwɛmu afoforo de ahu nea ɛde ba. Sɛ nhwɛso no, mogya mu nhwehwɛmu a wɔbɛyɛ de ahwɛ sɛnea wo mmerɛbo no yɛ adwuma ne sɛnea wo asaabo yɛ adwuma , ne sɛnea wɔyɛ wo nsu mu nhwehwɛmu . Esiane sɛ hyperammonemia betumi asɛe ntini a ɛwɔ nipadua no mfinimfini no na ɛde nkwa ato asiane mu nti, wo duruyɛfo no betumi ayɛ mfonini ho nhwehwɛmu te sɛ CT (computed tomography) scan anaa MRI (magnetic resonance imaging) scan nso de ahwɛ sɛ nsɛnnennen bi a ɛka amemene no wɔ hɔ anaa.

Dɛn ne ayaresa ahorow a wɔde sa hyperammonemia?

Ayaresa no gyina nea ɛde ba no so. Sɛ nhwɛso no, wɔ ɔpanyin mu no, efi mmerɛbo mu yare anaa mmerɛbo mu amemene mu yare, anaasɛ wɔ abofra a wɔawo no foforo mu no, efi urea cycle disorder (UCD). Wɔ acute hyperammonemia mu no, botae titiriw ne sɛ wɔbɛtew ammonia dodow a ɛwɔ mogya no mu so na wɔadi nsɛnnennen pɔtee te sɛ amemene mu akisikuru ne nhyɛso a ɛkɔ soro a atwa amemene no ho ahyia (intracranial hypertension) so.

• Sɛ akokoaa a wɔawo no foforo nya hyperammonemia a, nnuruyɛfo begyae protein a wɔde ma wɔn (efisɛ ammonia na ɛba bere a wɔayam protein no) na wɔama no glucose, asikre aduru bi mmom na ama wɔanya calories. Wɔde ɔkwan bi a wɔfrɛ no hemodialysis nso bedi dwuma . Nea ɛka eyi ho ne sɛ wɔbɛhohoro akokoaa no mogya mu na wɔafa afiri a wɔde yi mogya mu ne ade titiriw bi a wɔde yiyi mu (te sɛ asaabo a wɔde ayɛ) so yi ammonia fi hɔ.
• Wɔma nnipa a wɔwɔ urea cycle enzyme deficiency fã bi (UCD) a wonya hyperammonemia esiane adwennwen nti, te sɛ hyperammonemia a adwennwen de ba no nso protein a wɔtwe ne glucose sɛ calories. Sɛ wɔn ammonia dodow so antew wɔ nnɔnhwerew kakraa bi akyi wɔ ayaresa a edi kan no mu nkutoo a, wɔyɛ mogya mu nhwehwɛmu.
• Ayaresa a wɔde sa mmerɛbo mu amemene mu yare ne sɛ wɔbɛtew ammonia a ɛba dwensɔtwaa mu no so. Ayaresa a edi kan ne nnuru a wɔnom a lactulose ne lactitol wom . Saa asikre ahorow yi brɛ ammonia a ɛba dwensɔtwaa mu no ase na ɛtwetwe.

Ebia nnuruyɛfo bɛkamfo aduan a wɔde ka aduan ho te sɛ eyinom akyerɛ wɔn na wɔaboa nnipa a wɔwɔ urea kyinhyia mu haw no ma wɔatew wɔn sɛnkyerɛnne ahorow a ɛtaa ba no so:

• L-carnitine a wɔde yɛ aduru
• L-ornithine-L-aspartate a wɔde yɛ aduru
• Arginine a wɔde yɛ aduru

So akwan bi wɔ hɔ a yebetumi afa so akwati tebea yi?

Esiane sɛ nneɛma pii na ɛde hyperammonemia ba nti, ɛnyɛ tebea horow no nyinaa na wobetumi asiw ano. Nanso, wubetumi ayɛ nneɛma bi de asiw mmerɛbo mu nyarewa ahorow bi ano, titiriw nea ɛfa w’aduan ne w’asetra kwan ho. Sɛ wowɔ asiane mu sɛ wubenya mmerɛbo mu yare a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ yɛ nsakrae ahorow yi wɔ w’asetra mu:

• Ɛnyɛ hwee sɛ wobɛkwati nsa a wobɛnom anaasɛ wobɛto ano hye.
• Kwati nnuan ne anonne a trans srade anaa atoko srade a fructose pii wom.
• Nea ɛbɛyɛ na mmerɛbo no ansɛe no, hwɛ yiye paa bere a wode nnuru a wɔkyerɛw ma obi ne nea wɔtɔn a wɔmfa nnuru nhyɛ mu redi dwuma no.
• Apɔw-mu-teɛteɛ a wɔyɛ daa .
• Nam kɔkɔɔ a wodi no ano hye.

Sɛnea ɛbɛyɛ na wɔasiw Reye’s syndrome, tebea a ɛma mmofra ne mpanyimfo nkumaa mu yare no ano no, mma mmofra aspirin mma mmoawa a wɔanya ɔyare mmoawa (te sɛ atiridii anaa akisikuru) ho sɛnkyerɛnne ahorow no, gye sɛ oduruyɛfo kamfo kyerɛ pɔtee. Urea cycle defects (UCDs) ho yɛ na, nanso awosu mu nhwehwɛmu wɔ hɔ de hwɛ sɛ wowɔ awosu mu nkwaadɔm a ɛde ba anaa. Wo ne wo duruyɛfo nka eyi ho asɛm.

Dɛn ne nkɔmhyɛ a ɛfa tebea yi ho?

Hyperammonemia, kyerɛ sɛ, tumi a obi tumi nya ahoɔden no, gyina nneɛma pii so:

• Sɛnea wo ammonia dodow kɔ soro.
• Bere tenten a wɔde ama ammonia dodow no akɔ soro.
• Dɛn na ɛde hyperammonemia ba?

Mpɛn pii no, anidaso a ɛwɔ hɔ sɛ wobenya hyperammonemia no nyɛ papa. Sɛ wɔansa anaasɛ wɔansa no akyiri a, amemene a ɛho ahonhon a wontumi nsakra no ne nnipa dodow a wowuwu wɔ abusuabɔ. Nea ɛyɛ awerɛhow no, ɛmfa ho sɛnea wɔde hyperammonemia a emu yɛ den sa abofra a wɔawo no foforo yare ntɛmntɛm anaasɛ wɔyɛ no basabasa no, biribiara nni hɔ a ɛkyerɛ sɛ nea ebefi mu aba no bɛyɛ papa. Wɔ United States no, mfeɛ 11 a nnipa a wɔwɔ urea cycle defects (UCDs) a wɔnya hyperammonemia wɔ wɔn nkwa nna mu no yɛ bɛyɛ 35%. Wɔn a wonya hyperammonemia akyiri yi wɔ wɔn nkwa nna mu no, wɔn a wonya nkwa no bɛyɛ 87%. Wɔabɔ amanneɛ sɛ ayarefo a wɔwɔ mmerɛbo mu amemene mu yare a emu yɛ den esiane hyperammonemia nti nkwa nna yɛ 42% ne 23%.

Dɛn ne nsɛnnennen a ebetumi afi hyperammonemia mu aba?

Sɛ wɔansa tebea yi ntɛm a, ammonia dodow a ɛkɔ soro no betumi asɛe ntini a ɛwɔ mfinimfini no na ɛde ɔhaw ahorow a ɛde nkwa to asiane mu aba. Nsɛnnennen a ɛtete saa no bi ne:

• Amemene mu akisikuru
• Nhyɛso a ɛkɔ soro wɔ amemene no ho (Intracranial hypertension) .
• Amemene mu akisikuru – Eyi taa fi amemene no a ɛho ahonhon ne nhyɛso a ɛkɔ soro wɔ amemene no ho.
• Coma
• Owuo

Sɛ obi wɔ hyperammonemia a emu nyɛ den a enni sabea bere tenten a, obetumi anya adwene mu dɛmdi ne nneyɛe ne adwenemyare a ɛtra hɔ daa.

Bere bɛn na ɛsɛ sɛ yɛkɔ oduruyɛfo nkyɛn?

Sɛ wo anaa obi a wodwene no wɔ hyperammonemia ho sɛnkyerɛnne a, frɛ 911 ntɛm ara anaa kɔ ayaresabea a ɛbɛn wo. Eyi nyɛ biribi a ɛsɛ sɛ wɔtwentwɛn so. Sɛ wowɔ mmerɛbo mu yare anaasɛ urea cycle enzyme a enni wo fã bi a, ɛho hia yiye sɛ wobɛkɔ wo duruyɛfo nkyɛn daa na wahwɛ wo tebea no so na wahwɛ wo ammonia dodow.

Hyperammonemia yɛ tebea a emu yɛ den a nneɛma pii betumi de aba. Sɛ wo, wo ba, anaa wo ba no wɔ saa sɛnkyerɛnne yi a, hwehwɛ mmoa ntɛm ara. Sɛ wowɔ mmerɛbo mu yare, anaasɛ obi wɔ w’abusua mu wɔ urea cycle disorders (UCDs) a, wo ne wo duruyɛfo nka asiane a ɛwɔ hɔ sɛ wubenya hyperammonemia ho asɛm. Wɔwɔ hɔ sɛ wɔbɛboa wo.

Nea etwa to no, kae eyi.

Okay, enti nneɛma a ɛho hia paa a ɛsɛ sɛ wokae fi nea yɛaka ho asɛm no mu bi ni:

• Hyperammonemia yɛ ammonia a ɛdɔɔso wɔ mogya no mu a ɛyɛ hu. Eyi pira yɛn amemene ne yɛn ntini ahorow no kɛse.
• Nneɛma pii betumi ama eyi aba. Mmɛn mu haw ne urea cycle disorders (UCDs) ne nneɛma atitiriw a ɛde ba.
• Ɛsono sɛnea yare no ho sɛnkyerɛnne no gyina sɛnea tebea no mu yɛ den ne mfe a obi adi so. Ebetumi afi sɛnkyerɛnne ahorow a emu nyɛ den te sɛ akisikuru, ɔfe, ne tiyɛ so akosi sɛnkyerɛnne a emu yɛ den te sɛ adwene a ɛyɛ basaa, akisikuru, ne komayare so. Ɛsɛ sɛ mmofra a wɔawo wɔn foforo nso dwen wɔn yare no ho sɛnkyerɛnne ho titiriw.
• Sɛ wowɔ sɛnkyerɛnne ahorow a emu yɛ den a, ɛsɛ sɛ wohwehwɛ aduruyɛfo afotu a ɛnkyɛ. Eyi betumi ayɛ nkwa anaa owu tebea.
• Ayaresa no gyina nea ɛde ba no so. Ayaresa ntɛm betumi atew ammonia dodow so na asiw nsɛnnennen so.
• Bere a wontumi nsiw nneɛma bi a ɛde ba no ano no, wobetumi atew asiane ahorow bi so denam asetra pa a wobɛkɔ so akura mu ne wo mmerɛbo a wobɛhwɛ so yiye so .
• Sɛ́ ebia wowɔ mmerɛbo mu yare anaasɛ obi a ɔwɔ w’abusua mu wɔ UCD no, ɛho hia sɛ wokɔ aduruyɛ mu nhwehwɛmu daa.

Mma wo werɛ mmfi sɛ, wunim w’akwahosan yiye. Sɛ wote nka sɛ biribi soronko anaa ɛyɛ soronko a, nsuro sɛ wo ne oduruyɛfo bɛkasa. Hyperammonemia, ammonia, mmerɛbo, urea kyinhyia, amemene, sɛnkyerɛnne ahorow, ayaresa