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Diagnosis relies on the combination of clinical suspicion and the measurement of ammonium, lactate, and amino acids in plasma and organic acids and orotic acid in urine. Treatment involves nitrogen restriction combined with the stimulation of alternate pathways of waste nitrogen excretion. More recently liver transplantation has been performed as enzyme replacement therapy. The outcome is poor in children who survive prolonged neonatal hyperammonemic coma, with most manifesting developmental disabilities. The etiology of neuronal injury in this disorder is unclear but may involve some combination of ammonia\/amino acid accumulation, neurotransmitter alterations, and excitotoxic injury. Gene therapy holds the promise of improved treatment in the future.<\/jats:p>","DOI":"10.1002\/ana.410350204","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T15:59:54Z","timestamp":1104595194000},"page":"133-141","source":"Crossref","is-referenced-by-count":62,"title":["Inborn errors of urea synthesis"],"prefix":"10.1002","volume":"35","author":[{"given":"Mark L.","family":"Batshaw","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,10,8]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"51","volume-title":"Nutritional biochemistry and metabolism with clinical applications","author":"Linder MC","year":"1985"},{"key":"e_1_2_1_3_2","first-page":"1193","volume-title":"Modern nutrition in health and disease","author":"Holtzman 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