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One serious adverse event (SAE) was reported, one patient after 12 weeks of treatment with l glutamine, presented with disturbed consciousness level, fever, vomiting, right upper quadrant abdominal pain, darkening of his urine with a deepening of his jaundice, and tachypnea, elevated transaminases tenfold with direct hyperbilirubinemia, derangement of kidney functions with abnormal bleeding profile, and metabolic acidosis with a positive anion gap, patient was diagnosed as sickle cell hepatopathy (SCH), admitted to PICU and was managed with supportive measures together, with exchange transfusion

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doi: 10.1038/nature10558 161 KayagakiNStoweIBLeeBLORourkeKAndersonKWarmingSet al