General Neurology
Hospital-based neurologic care
Apr. 27, 2024
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Toll Free (U.S. + Canada): 800-452-2400
US Number: +1-619-640-4660
Support: service@medlink.com
Editor: editor@medlink.com
ISSN: 2831-9125
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Ammonia is detoxified through its conversion to urea by the enzymes in the small boxes, whose abbreviations are spelled out below. OTC catalyzes the synthesis of citrulline from carbamoyl phosphate and ornithine. Deficiency of OTC (highlighted in red) causes hyperammonemia along with accumulation of plasma glutamine and decreased plasma citrulline and arginine concentrations. Urinary orotic acid is markedly elevated. NAGS, N-acetylglutamate synthase; CPS1, carbamoyl phosphate synthetase 1; OTC, ornithine transcarbamylase; ASS, argininosuccinate synthetase; ASL, argininosuccinate lyase; ARG1, arginase 1. (Adapted from Zschocke and Hoffmann 2011.)