[Dynamic study of plasma and urine amino acid patterns after an oral load of tryptophan. Application to a patient with a complex deficiency syndrome].
The aim of this work was to show that the dynamic study of the amino acid pattern in plasma and urine following an oral load of tryptophan might confirm anomalies suggested by inconsistent clinical data and below-normal biological values. Such oral loads were administered to five control subjects and one patient who had recovered from a celiac condition but was suffering from a complex deficiency syndrome associating a polyneuritis due to a lack of folic acid and the excretion of blue-colored transpiration. Thirty minutes following the load a slowing in the rate of tryptophan absorption was observed (p less than 0.05) and, during the first 6 hours, increased urinary excretion of tryptophan (p less than 0.01) and indican (p less than 0.05). Similarly, changes in the metabolism of other amino acids were either revealed or accentuated by this oral load test (ornithine, glycine, lysine, phenylalanine). It is probable that in this patient a problem of tubular re-absorption led to tryptophan being less available for metabolization along the kynurenine pathway, accounting for the increase in urinary excretion of the amino acids concerned. The diagnosis put forward is that of an unexpressed form of Hartnup's disease in association with a folic acid deficiency.
D000328:Adult; D000596:Amino Acids / Q000097:blood / Q000378:metabolism* / Q000652:urine; D003677:Deficiency Diseases / Q000378:metabolism*; D006801:Humans; D008297:Male; D012016:Reference Values; D014364:Tryptophan / Q000378:metabolism
D000596:Amino Acids; D014364:Tryptophan
Etude dynamique des aminoacidogrammes plasmatiques et urinaires après charge orale en tryptophane. Application à un sujet atteint d'un syndrome carentiel complexe.