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While this appears to be a novel finding (23, 24), abnormal levels of urinary hypoxanthine have been reported in autism and abnormal plasma and urine levels of other purines are noted in some rare monogenic metabolic disorders that are sometimes associated with autism (21, 74, 75)

Under normal circumstances, most of the portal vein ammonia load is metabolized to urea in hepatocytes in the Krebs-Henseleit (urea) cycle during the first pass through the liver