BIOCHEMICAL INVESTIGATION OF HISTIDINAEMIA.
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A 6-month-old child with a history of recurrent infections, convulsions, and retarded development had biochemical findings which were typical of histidinaemia. The enzyme histidase has been shown to be absent from the skin of the patient. The results of histidine-loading experiments in the parents of the child suggest that they may both metabolise this amino-acid abnormally. A simple method of estimating histidine in plasma and urine is described. (+info)
DETECTION OF FORMIMINO-GLUTAMIC AND UROCANIC ACIDS IN URINE BY MEANS OF THIN-LAYER CHROMATOGRAPHY.
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A simple and rapid method has been developed for the simultaneous separation and semi-quantitative estimation of formimino-glutamic and urocanic acids in urine. The urinary excretion of these compounds in a group of normal subjects and in a number of illustrative cases has been determined. In view of current opinion that it is the total of these two metabolites of histidine which is the significant figure in clinical investigation, their simultaneous separation and measurement is an important advantage of the method. (+info)
PRACTICAL EVALUATION OF THE FIGLU TEST IN PREGNANCY WITH SPECIAL REFERENCE TO THE WHITE CELL CHANGES.
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Using slight modifications to the method of Kohn, Mollin, and Rosenbach (1961) the histidine loading test has been carried out in 210 pregnant women. Seventy per cent. of the cases showed complete haematological correlation and this rose to 87% when marrow puncture was performed. False positive results occurred in some cases showing active erythropoiesis in response to iron therapy. False negative results were noted when other complications in addition to anaemia were present, and it was felt that these might interfere with the metabolism of histidine. In some cases the histidine test anticipated the haematological change.Seventy-seven per cent. of women with multiple pregnancies showed evidence of folic acid deficiency. Only in a few cases was the test positive before the 25th week of pregnancy. These were either cases of multiple pregnancy, haemolytic anaemia, malabsorption syndrome, or women with a recent history of megaloblastic anaemia of pregnancy. The test appears to confirm the significance of white cell changes as an indication of folic acid deficiency in pregnancy. (+info)
Evaluation of macrocytosis.
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Macrocytosis, generally defined as a mean corpuscular volume greater than 100 fL, is frequently encountered when a complete blood count is performed. The most common etiologies are alcoholism, vitamin B12 and folate deficiencies, and medications. History and physical examination, vitamin B12 level, reticulocyte count, and a peripheral smear are helpful in delineating the underlying cause of macrocytosis. When the peripheral smear indicates megaloblastic anemia (demonstrated by macro-ovalocytes and hyper-segmented neutrophils), vitamin B12 or folate deficiency is the most likely cause. When the peripheral smear is non-megaloblastic, the reticulocyte count helps differentiate between drug or alcohol toxicity and hemolysis or hemorrhage. Of other possible etiologies, hypothyroidism, liver disease, and primary bone marrow dysplasias (including myelodysplasia and myeloproliferative disorders) are some of the more common causes. (+info)
The effects of chronic drug administration on hepatic enzyme induction and folate metabolism.
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1 Patients on prolonged treatment with anticonvulsant and phenothiazine drugs exhibited lower than normal concentrations of folate in serum and erythrocytes, and showed increased urinary FIGLU excretion after histidine loading; urinary excretion of D-glucaric acid was also increased suggesting induction of the hepatic microsomal enzymes. 2 Folate deficiency by enzyme-inducing drugs was seen to be determined more by the duration of therapy than by the nature of the drugs. Excretion of FIGLU was increased by 70% by 2-5 years of treatment with anticonvulsant, phenothiazine or tricyclic drugs, and by 200% after 6 or more years. 3 Hepatic microsomal enzyme induction, as measured by D-glucaric acid excretion, was greatest after 2-5 years treatment. 4 It is suggested that the increased requirements for folate, resulting from microsomal enzyme induction, lead to folate deficiency and this subsequently limits enzyme induction, leading to adverse drug side-affects. 5 The dietary folate of hospitalized patients would seem to be generally inadequate for patients on long term treatment with enzyme-inducing drugs. (+info)
Experimental maternal and neonatal folate status relationships in nonhuman primates.
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The influence of maternal dietary folic acid intake on folate status was studied in Cebus albifrons monkeys by feeding 10 or 250 micrograms/100 kcal dietary folic acid during pregnancy and 4 wk postpartum. Maternal, infant, and nonpregnant hematologic indices; blood and liver folate concentrations; and urinary formiminoglutamic acid excretion all varied with dietary folate intake and pregnancy status as did milk folate concentration in lactating dams. Maternal folate status, determined by plasma, red blood cell, and milk folate concentrations, as well as urinary formiminoglutamic acid excretion, all were correlated significantly with liver folate concentrations in neonates (r = 0.740, r = 0.919, r = 0.936, and r = -0.851, respectively). Results in these primates showed that neonatal folate status was related significantly to the dietary folate intake and folate status of the mother during pregnancy and lactation. (+info)
Folate requirement and metabolism in nonpregnant women.
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Folate metabolism and requirements were studied in 10 adult nonpregnant women maintained for 92 d in a metabolic unit. After a folate depletion period of 28 d, the subjects received increasing supplements of folate from food items or as pteroylmonoglutamic acid (PGA). Plasma folate levels fell 60% during the depletion period and continued to fall until 200 micrograms/d of naturally occurring food folates were provided. Supplements of 300 micrograms/d of naturally occurring folates produced a small rise in plasma folate levels although erythrocyte folate levels continued to fall. Lymphocyte deoxyuridine suppression, neutrophil hypersegmentation, and other measurements related to folate metabolism were performed. When compared with PGA, dietary folates appeared to be no more than 50% available. A daily intake of 200-250 micrograms of dietary folates appears to meet the folate requirements of nonpregnant adult women whereas an intake of 300 micrograms/d provides an allowance for storage. (+info)
Folic acid metabolism in vitamin B12-deficient sheep. Effects of injected methionine on liver constituents associated with folate metabolism.
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1. The effects of injected l-methionine (2g every second day for 28 days) on liver folates and other constituents of liver associated with folate metabolism were studied in vitamin B(12)-deficient ewes and their pair-fed controls receiving vitamin B(12). The dose rate of methionine used was sufficient to restore almost to normal the elevated excretion in the urine of formiminoglutamate in the deficient animals. 2. Liver folates active for Lactobacillus casei, Streptococcus faecalis R and Pediococcus cerevisiae were severely depressed in deficient livers and were partly restored by methionine. Analysis of the folates after ion-exchange chromatography showed that the major effect of methionine was to increase the concentrations of tetrahydrofolates and formyltetrahydrofolates. Methyltetrahydrofolates were also increased, but there was no effect of methionine on the small amounts of incompletely reduced folates present in deficient livers. The folates present were predominantly penta-, hexa- and hepta-glutamates whether or not animals received vitamin B(12) or methionine. 3. Concentrations of ATP, NAD(+), NADH and NADPH were lower in freeze-clamped liver from vitamin B(12)-deficient sheep than in liver from pair-fed, vitamin B(12)-treated sheep. These changes were not affected by methionine which was also without effect on the elevated K(+)/Na(+) ratios found in deficient livers. 4. The livers of vitamin B(12)-deficient animals contained lower concentrations of choline and higher concentrations of lipid than their pair-fed controls. These effects were reversed by methionine. (+info)