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None of the patients required urgent liver transplantation, though five eventually underwent transplant for recurrent metabolic crises. We intend that this novel observation will initiate further investigations into the pathophysiology of liver dysfunction in OTC\u2010deficient patients, and ultimately lead to the development of therapies and prevent the need for liver transplant.<\/jats:p>","DOI":"10.1002\/ajmg.a.62031","type":"journal-article","created":{"date-parts":[[2020,12,25]],"date-time":"2020-12-25T08:13:20Z","timestamp":1608884000000},"page":"909-915","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Acute liver dysfunction with delayed peak of serum aminotransferase levels as a presentation of ornithine transcarbamylase deficiency in females"],"prefix":"10.1002","volume":"185","author":[{"given":"Kathryn","family":"Clarkston","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Gastroenterology, Hepatology, and Nutrition Cincinnati 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