# A Possible Case of Acquired Urea Cycle Disorder in a Critical Care Patient

## TL;DR

A middle-aged woman with alcohol-related liver disease developed a severe, fatal case of acquired urea cycle disorder during a long critical care stay.

## Contribution

This case highlights a rare and fatal instance of acquired UCD in an adult with alcohol-related liver disease.

## Key findings

- The patient developed severe, refractory hyperammonemia on day 67 of her critical care stay.
- The case suggests a possible link between alcohol-related liver disease and acquired urea cycle disorder.
- The outcome was fatal despite critical care interventions.

## Abstract

Acute urea cycle disorder (UCD) presentation in patients can be challenging to manage, and the outcome can be deleterious if not promptly detected and urgently managed. This disorder is rare and can either be inherited or acquired. More descriptions of this disorder are noted in the paediatric population. We present a possible clinical scenario of acquired UCD in a middle-aged female with alcohol-related fatty liver disease who had a prolonged critical care admission, which culminated in an acute finding of a severe refractory acute hyperammonemia on her 67th day of critical care stay with a fatal outcome.