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Fluorometric Determination of Pyruvate and  -Ketoglutarate in Cerebrospinal Fluid and Plasma of Infants and ChildrenA Simple Test That Screens for Metabolic Disorders
Jean Holowach Thurston, MD;
Richard E. Hauhart;
Jo Louise Seltzer, PhD;
David B. McDougal, Jr, MD
Arch Neurol. 1976;33(11):764-768.
Abstract
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• Levels of pyruvate and  -Ketoglutarate in the cerebrospinal fluid (CSF) of 26 children, aged 4 months to 51/2 years, with febrile seizures and of 19 children, aged 4 months to 14 years, with the diagnosis of epilepsy were not different from values seen in 119 "normal" children 8 days to 14 years of age. The CSF samples from 24 adults, 24 to 81 years of age, suspected of having a herniated disk were also examined. In the pediatric age group, the data showed a highly significant downward trend of CSF and plasma -ketoglutarate values with age; pyruvate values did not change.
A correlation of the values of the two keto acids in the blood and CSF of 42 other children without apparent neurologic disease was also made. Findings in a child with thiamine deficiency suggest that CSF -ketoglutarate may be a more sensitive indicator of deficiency than plasma -ketoglutarate or pyruvate.
Measurements of these keto acids in plasma and CSF may be diagnostically useful in a variety of metabolic disorders. Findings in 155 children from birth (20 minutes) to 17 years of age without neurologic disease are submitted as a standard of reference.
Author Affiliations
From the Edward Mallinckrodt Department of Pediatrics, Division of Neurology (Dr Thurston and Mr Hauhart), St Louis Children's Hospital, and the Department of Pharmacology and the Beaumont-May Institute of Neurology (Drs Seltzer and McDougal), Washington University School of Medicine, St Louis.
Footnotes
Accepted for publication March 22, 1976.
Reprint requests to St Louis Children's Hospital, 500 S Kingshighway, St Louis, MO 63110 (Dr Thurston).
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