5-Oxoprolinuria in hyperammonemic encephalopathy: Coincidence or worsening factor?

- Malnutrition is a risk factor of hyperammonemia and 5-oxoprolinuria.
- Hyperammonemia may be responsible for encephalopathy, even if it is marginally increased.
- 5-oxoproline may be a source of glutamate in astrocytes, accelerating glutamine synthesis in the brain.
- Consider asking patients suffering from malnutrition for these parameters.