Abstract
Several explanations for the encephalopathy in RS including false neurotransmitter activity have been postulated. Our group has recently demonstrated preliminary evidence of a disturbance in tyrosine metabolism resulting in hypertyraminemia in 14 patients (Ped.64:76,1979). Additionally, we have observed hyperprolactinemia in three cases of stage IV RS (Lancet 2:1097,1979).
Utilizing the same radioimmunoassay techniques, plasma tyramines (TM) were measured on 16 additional RS patients. Plasma TM on admission were significantly elevated 6.65 ng/ml ± 1.86 (mean ± S.E.M., range 0.1-36.2) p<0.003 when compared to the control patients without liver disease (range 0.7-1.1 ng/ml). A double antibody RIA was utilized to measure daily serum prolactin in the same 16 RS patients. Mean peak serum prolactin levels for patients presenting in various stages of coma were: I 15.07(7-28), II 13.7(7-33), III 34.7(14-66), IV 50-6(13-73). The mean peak serum prolactins in patients presenting in stages III and IV were significantly higher than those presenting in stages I and II (p<0.01) and positively correlated with admission plasma TM (p<0.04 r=0.61).
These findings of hyperprolactinemia and significantly elevated plasma TM in the severely encephalopathic patients indirectly confirm evidence of a “false neurotransmitter” contribution to the encephalopathy. Hyperprolactinemia may select a subpopulation of RS patients with potential to benefit from attempts to correct neurotransmitter disturbance with agents such as L-dopa or bromocriptine.
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Newman, S., Faraj, B., Caplan, D. et al. 1596 HYPERTYRAMENEMIA AND HYPERPODIACTINEMIA IN REYE'S SYN-DROME: CORROBORaTION OF THE FALSE NEUROTRANSMITTER HYPOTHESIS. Pediatr Res 15 (Suppl 4), 709 (1981). https://doi.org/10.1203/00006450-198104001-01613
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DOI: https://doi.org/10.1203/00006450-198104001-01613