case_images: PMC10912554_01
case_images: Course of serum ammonia level.
case_images: fped-12-1278047-g001.jpg
case_images: PMC10912554_01_fped-12-1278047-g001.jpg
case_images: F1
case_images: Blood tests revealed evidence of acute liver failure: conjugated bilirubin 0.92 mg/dl (<0.2), total bilirubin 7.0 mg/dl (0.2-1), INR 2.45, aPTT 86.5 s (31-54), thrombin time 26.2 s (16.2-19.1), ammonia level 850 microg/dl (45-109) (Figure 1), while transaminases were still within the reference range [AST 86 U/L (<90), ALT 25 U/L (<60)]. Ammonia levels remained slightly elevated (150-290 microg/dl) (Figure 1).