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(3) renal â glutamine break down in proximal tubule (combines with H+ -> NH4+ and eliminated) CAUSES OF HYPERAMMONAEMIA. Overproduction of ammonia. Protein/ amino acid load. gastrointestinal hemorrhage. gastric bypass. multiple myeloma. allogeneic stem cell transplantation.
Increased entry of ammonia to the brain is a primary cause of neurologic disorders, such as congenital deficiencies of urea cycle enzymes, hepatic encephalopathies, Reye syndrome, several other metabolic disorders, and some toxic encephalopathies.