2608 K. SCHREIER 
also refs. 68, 69). As indicated before, the liver plays an extremely important role in 
the homeostasis of blood amino acid levels. Especially during the unstable post- 
natal regulatory period, anoxemic toxic and viral diseases which damage the liver 
tissue provoke a very marked hyperaminoacidemia and, of course, a hyperamino- 
aciduria as well due to the so-called “overflow” mechanism. In later life the changes 
usually are less pronounced. In agreement with results of various authors (cf. refs. 
70-78) in studies mainly on adults we have found in children, first of all, a disturbance 
in the turnover of methionine, as well as of lysine, arginine and the cyclic amino 
acids. The cause for the increased concentration of these amino acids in the body 
fluids in cases of several liver disorders appears to be a disturbance in deamination 
and desulfuration and in the anabolic capacity of this organ. Besides this, one should 
not forget the hepato—renal relations (7.e. tubular damage, cf. ref. 79). 
TABLE Tit 
SOME AMINO ACIDS IN SERUM OF INFANTS WITH ENTERITIS 
Method: microbiological assay 
Average values: ug/ml 


Amino acid Mild form Severe form Toxic enteritis 
Isoleucine Pitoe 22.6 35.6 
Leucine 27.3 31.0 64.3 
Methionine 5e3 6.7 14.8 
Phenylalanine 26.8 27-4 33-3 
Tryptophane 12.6 16.9 20.6 
Tyrosine 18.6 PW 22.0 
Valine 31.8 42.8 51.3 
Infants having severe enteritis demonstrate a special form of hyperaminoacidemia 
and hyperaminoaciduria. FINKELSTEIN fittingly called the severe forms of infantile 
dehydration “coma trophopathicum”, emphasizing the similarity with coma he- 
paticum. 
We have made an extensive study of the amino acids of the blood and urine from 
infants of varying ages who had enteritis in degrees ranging from mild to very 
severe. In those cases studied, we found slight to extreme alterations in amino acid 
levels, correlating with the clinical picture (Table III). Our findings have been con- 
firmed by KLEINBAUM® and LOEB AND ENGELEN®! who found disturbances in amino 
acid metabolism especially in the “toxic-infectious” form of severe enteritis. 
The degree of the hyperaminoaciduria is influenced greatly by the accompanying 
kidney damage which is very severe in some cases 82-84, 
There exist only a few investigations on the effect of the basic nutritional sub- 
stances on the amino acid levels of plasma®*—8’; this is especially true for infants 
and children. The determination of amino acids in the serum of children®’ following 
a protein-rich meal showed a rise in the individual amino acids which, as in adults89-%8 
did not correspond to the quantity of the acids in the meal. The behavior of amino 
References p. 279/283 
