He presented with hypoglycemia, lactic acidosis (lactate 5 mmol/l; reference < 2.1 mmol/l), hyperammonemia (188 μmol/l; reference < 55 μmol/l), hepatopathy (aspartate transaminase 176 U/l, reference < 70 U/l; alanine transaminase 141 U/l, reference < 49 U/l; lactate dehydrogenase 1101 U/l, reference < 570 U/l), and severe hypertrophic cardiomyopathy (N-terminal brain natriuretic peptide 13,445 ng/l; reference < 84 ng/l). Here, GPT is linked to Hyperammonemia.