Severe hyperhomocysteinaemia and 5-oxoprolinuria secondary to antiproliferative and antimicrobial drug treatment.
A hitherto healthy 7-year-old girl underwent antiproliferative and antibiotic treatment owing to the diagnosis of T-cell lymphoma and concomitant bacterial infection. She developed an encephalopathic crisis associated with metabolic acidosis, hyponatraemia and severe hyperhomocysteinaemia and 5-oxoprolinuria. Laboratory tests normalized completely after recovery. Primary defects in glutathione metabolism could be excluded.
Schwahn
B
B
Clinic for General Pediatrics, University Children's Hospital, Moorenstrasse 5, D-40225, Düsseldorf, Germany. schwahn@med.uni-duesseldorf.de
Kameda
G
G
Wessalowski
R
R
Mayatepek
E
E
D000138:Acidosis; D000838:Anions; D000890:Anti-Infective Agents / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects; D002648:Child; D005260:Female; D005978:Glutathione / Q000378:metabolism; D006710:Homocysteine / Q000737:chemistry; D006801:Humans; D020138:Hyperhomocysteinemia / Q000209:etiology*; D016399:Lymphoma, T-Cell / Q000188:drug therapy*; D010672:Phenytoin / Q000737:chemistry; D011110:Polymorphism, Genetic; D011761:Pyrrolidonecarboxylic Acid / Q000652:urine*; D013997:Time Factors
D000838:Anions; D000890:Anti-Infective Agents; D000970:Antineoplastic Agents; D006710:Homocysteine; D010672:Phenytoin; D005978:Glutathione; D011761:Pyrrolidonecarboxylic Acid