Glutaric, 3-hydroxypropionic, and lactic aciduria with metabolic acidemia, following extensive small bowel resection.
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Biomedical subjects
Publications and source records attributed to B S Miles.
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A patient with methylmalonic and beta-hydroxy-n-valeric aciduria, apparently due to deficiency of methylmalonyl-CoA mutase, is described. The excretion of beta-hydroxy-n-valerate did not parallel that of beta-hydroxypropionate and methylmalonate but was observed, together with beta-keto-n-valerate, only during ketosis. beta-Hydroxy-n-valerate excretion thus correlates primarily not with the pool size of propionyl-CoA but with that of acetyl-CoA, and may occur during ketosis in any disorder causing accumulation of propionyl-CoA.
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Urine samples from 92 individuals of a healthy pediatric population ranging in age from less than 24 h to 12 years were analyzed for organic acid content (amino acids excepted). A few samples from adults were included for purposes of comparison. Acids were extracted by using an anion-exchange procedure, converted to trimethylsilyloxime derivatives, and analyzed by gas chromatography with the help of a small computer system. Identifications were confirmed by using a combined gas chromatograph/mass spectrometer/computer system. The data has been tabulated according to five pediatric age groups. Despite large individual variation within age groups, significant differences in amounts of several acids excreted (based on urinary creatinine concentration) have been determined between age groups. Such differences might be due to one or a combination of several factors, including changes with age in creatinine excretion, in physiologic maturity, and in diet. Such data may help to provide a basis for diagnosing metabolic abnormalities in pediatric patients.
1. An unknown compound has been isolated in the acidic fraction of urine samples taken from several children suspected of having metabolic disorders. 2. This unknown has been characterized using a gas chromatograph/mass spectrometer/computer system. Both the high and low resolution mass spectra have been determined and a structure proposed. 3. Authentic samples were synthesized and compared to the unknown and a final proof of structure is presented. The compound, 4-hydroxycyclohexane-1-carboxylic acid, is suspected to come from a dietary source but the actual genesis will be determined in future work.
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