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The clinical course of the present case and results of a genomic analysis of the OTC gene. (a) The serum ammonia level worsened rapidly from hospital day 1 to day 2 and improved rapidly after the administration of L-arginine on day 2. Her consciousness recovered on hospital day 5. (b) A genomic analysis revealed an Arg40His (c.119G>A) heterozygous mutation in the OTC gene.
