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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.
Gastrointestinal Bleeding. Gastrointestinal bleeding may cause an elevated blood ammonia level. Red blood cells contain a high concentration of protein. Significant bleeding, especially in the upper part of the digestive system, increases the protein load in the intestine and the production of ammonia.