{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T15:41:52Z","timestamp":1696088512536},"reference-count":17,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2011,10,20]],"date-time":"2011-10-20T00:00:00Z","timestamp":1319068800000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A 75\u2010year\u2010old Caucasian male presented with generalized seizures half\u2010hour post\u2010transurethral resection of the prostate surgery. The intra\u2010operative course was complicated by perforation of the posterior wall of the bladder neck during a difficult Foley catheter placement. This resulted in intraperitoneal extravasation of the glycine containing bladder irrigation fluid. An emergent laparotomy was performed, and 3.5\u20134\u2009<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content> of fluid was drained from the peritoneal cavity. Postoperative course was complicated by two seizures within a short interval. Patient developed profound hyponatremia (<jats:styled-content style=\"fixed-case\"><jats:roman>Na<\/jats:roman><\/jats:styled-content> of 109\u2009mEq\/<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>). However, measured serum osmolality was normal (283\u2009mOsm\/kg). The serum osmolality remained relatively stable, indicating that the absorbed glycine and its metabolites remained osmotically active in the intravascular space (until they were dialyzed as mentioned later), making the hyponatremia less pernicious and an unlikely cause of patient's symptoms. The encephalopathy and seizures were ascribed to accumulation of toxic metabolites of glycine, especially ammonia (serum level \u20131261\u2009mcmol\/<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>). During a complicated postoperative period, patient developed oligo\u2010anuric renal failure, and was started on slow low\u2010efficiency dialysis for 8 hours resulting in rapid lowering of serum ammonia levels and glycine with reversal of encephalopathy including seizures. There was no recurrence of encephalopathy, seizures, or metabolic acidosis. Although rare, glycine toxicity may be life threatening. The pathophysiology, need for early detection and the role of early use of renal replacement therapy in acute glycine toxicity is discussed below.<\/jats:p>","DOI":"10.1111\/j.1542-4758.2011.00611.x","type":"journal-article","created":{"date-parts":[[2011,10,20]],"date-time":"2011-10-20T07:15:34Z","timestamp":1319094934000},"source":"Crossref","is-referenced-by-count":2,"title":["Postprostatectomy seizures: A case report"],"prefix":"10.1111","volume":"15","author":[{"given":"Prasad","family":"Bichu","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine University of Missouri  Columbia Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gautam","family":"Phadke","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine University of Missouri  Columbia Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harbaksh","family":"Sangha","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine University of Missouri  Columbia Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhukar","family":"Misra","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine University of Missouri  Columbia Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,10,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11011\u2010008\u20109117"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","DOI":"10.1097\/00002727-199411000-00016","volume-title":"Fluid, Electrolyte and Acid\u2010Base Physiology: A Problem\u2010Based Approach","author":"Halperin ML","year":"1994"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei279"},{"key":"e_1_2_8_5_1","volume-title":"TURP Syndrome Complications in Anesthesiology","author":"Lobato EB","year":"2008"},{"key":"e_1_2_8_6_1","volume-title":"Glycine Encephalopathy. 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