AbbreviationsAEadverse eventALTalanine transaminaseALPalkaline phosphatasecPLIcanine pancreatic lipase immunoreactivityGIgastrointestinalL‐aspL‐asparaginaseIntroductionL‐asparaginase (L‐asp) is an enzyme commonly used in both human and veterinary medicine as part of multiagent chemotherapy protocols for lymphoproliferative malignancies. L‐asp works by depleting the peripheral blood of asparagine, a necessary amino acid for survival of lymphoid cells. While normal lymphoid cells are able to produce their own asparagine, neoplastic lymphoid cells cannot, leaving them reliant upon extracellular asparagine reserves. Adverse reactions to L‐asp are not common in dogs; however, previously reported reactions include anaphylaxis, pancreatitis, decreased protein synthesis, coagulopathies, hepatotoxicity, and more recently, hyperammonemic encephalopathy. Hyperammonemic encephalopathy is a rare complication of intensive chemotherapy in people characterized by increased serum ammonia concentration, normal liver function tests, and respiratory alkalosis. Hyperammonemic encephalopathy has been documented in people treated with several chemotherapy agents including cytarabine, vincristine, etoposide, L‐asp, cyclophosphamide, 5‐fluorouracil, and sunitinib. L‐asp has been reported to cause hyperammonemia in people with acute lymphoblastic leukemia and lymphoma. Two mechanisms of action have been described. First, asparagine is deaminated by asparaginase, which leads to the breakdown products of ammonia and aspartic acid, and thus accumulation of ammonia in the plasma. Glutamine metabolism is also diverted to asparagine synthesis, which is immediately deaminated by
Journal of Veterinary Emergency and Critical Care – Wiley
Published: Jan 1, 2018
Keywords: ; ; ; ; ;
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