ABSTRACT
Investigations of peroxisomal function were undertaken in an 8-year-old girl who developed motor difficulties at the age of 3.5 years and went on to develop a progressive ataxia and dysarthria. There were no other neurological abnormalities and she was of normal intelligence. Analysis of plasma very long-chain fatty acids revealed a normal C26 concentration and normal C24/C22 and C26/C22 ratios. Analysis of branched-chain fatty acids showed an elevated plasma phytanic acid concentration of 60 mumol/L (normal < 15) and a considerably elevated pristanic acid concentration of 50 mumol/L (normal < 2). Plasma concentrations of the C27 bile acids 3 alpha, 7 alpha-dihydroxycholestanoic acid (DHCA) and 3 alpha, 7 alpha, 12 alpha-trihydroxycholestanoic acid (THCA) and of the C29-dicarboxylic acid were also increased. We postulated that these results might be due to deficiency of the peroxisomal branched-chain acyl-CoA oxidase, but when oxidation of branched-chain fatty acids was studied in cultured skin fibroblasts it was found to be normal. Alternative explanations for the accumulation of branched-chain substrates for peroxisomal beta-oxidation are discussed. Treatment with a low-phytanic acid diet arrested the progression of the ataxia and led to a slight improvement.
Subject(s)
Ataxia/metabolism , Bile Acids and Salts/blood , Fatty Acids/blood , Fatty Acids/metabolism , Phytanic Acid/blood , Ataxia/therapy , Child , Female , Fibroblasts/metabolism , Humans , Oxidation-ReductionSubject(s)
Fatty Acids/blood , Microbodies/metabolism , Nervous System Diseases/diagnosis , Adolescent , Adrenoleukodystrophy/blood , Adrenoleukodystrophy/diagnosis , Adult , Child , Child, Preschool , Humans , Infant , Middle Aged , Nervous System Diseases/blood , Nervous System Diseases/etiology , Retrospective StudiesABSTRACT
A method for the quantification of phenylalanine in whole blood and plasma by isotope dilution gas chromatography-mass spectrometry is presented. The use of an uncommon derivative allows a simple extraction procedure and the most basic mass spectrometer. The relative standard deviation was found to be 1.3% within-batch and 2.1% between-batch under optimum conditions, and the detection limit was found to be 7 pmol injected. The ruggedness of the procedure and sample handling conditions were also examined.
Subject(s)
Phenylalanine/blood , Gas Chromatography-Mass Spectrometry , Humans , Indicators and Reagents , Reference StandardsABSTRACT
We describe an HPLC method for measurement of ratios of concentrations of very-long-chain fatty acids (VLCFA) in plasma. The method, which involves ultraviolet detection of p-bromophenacyl derivatives of fatty acids, is validated by comparison with a gas chromatographic-mass spectrometric (GC-MS) method. The correlation between the ratios of 24-carbon fatty acids to 22-carbon fatty acids (C24/C22) estimated by the two methods was close (r = 0.976) as was the correlation for the C26/C22 ratios (r = 0.947). Increased VLCFA ratios could be demonstrated by either technique in patients with adrenoleukodystrophy, Zellweger syndrome, and infantile Refsum's disease. The HPLC method also measures phytanate concentrations in plasma. Control VLCFA ratios (for subjects without peroxisomal disorders) obtained by the two methods agree well with those reported by Moser et al. (Ann Neurol 1984; 16:628-41). For subjects younger than one year, ratios for C24/C22 and C26/C22 fatty acids were significantly greater than in older subjects.
