Generalized convulsion resulted in hyperammonemia during treatment with tranexamic acid for hemoptysis.

BACKGROUND: Tranexamic acid is commonly used to treat various kinds of bleeding disorders. It has been shown to cause severe convulsions in animal experiments. AIMS: We report a patient who experienced a single convulsive seizure that resulted in transient hyperammonemia during treatment with tranexamic acid. CASE REPORT: A 68-year-old man was admitted and received tranexamic acid for persistent hemoptysis. After 5 days of admission, clonic convulsions that progressed to generalized seizures were noted following the intravenous administration of the tranexamic acid. Elevated ammonia level (233 μmol/l) was found. No further seizures occurred after immediate discontinuation of the drug. No other cause of seizures was found. The ammonia level on the following day normalized even without any treatment for the hyperammonemia.
CONCLUSIONS: This case highlights that generalized convulsion is a very rare, but serious adverse effect of tranexamic acid. Generalized convulsion should be considered as a potential cause of transient hyperammonemia.