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Related Experiment Videos

Allopurinol challenge test in children.

A B Burlina1, V Ferrari, C Dionisi-Vici

  • 1Department of Pediatrics, University of Padua, Italy.

Journal of Inherited Metabolic Disease
|January 1, 1992
PubMed
Summary

The allopurinol challenge test established normal urinary orotic acid excretion in children and adolescents. This test also identified elevated orotic acid levels in children with urea-cycle disorders, such as ornithine transcarbamylase deficiency.

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Area of Science:

  • Biochemistry
  • Pediatric Medicine
  • Metabolic Disorders

Background:

  • Establishing reference ranges for urinary orotic acid is crucial for diagnosing metabolic disorders in pediatric populations.
  • The allopurinol challenge test is a diagnostic tool used to assess purine metabolism and detect certain enzyme deficiencies.

Purpose of the Study:

  • To determine normal urinary orotic acid excretion levels in healthy children and adolescents following an allopurinol challenge.
  • To evaluate the utility of the allopurinol challenge test in identifying urea-cycle disorders, specifically ornithine transcarbamylase deficiency.

Main Methods:

  • A single oral dose of allopurinol (100-300 mg based on age) was administered to 44 healthy pediatric subjects (6 months to 17 years).
  • Urinary orotic acid levels were measured and normalized to creatinine to establish peak excretion values across different age groups.

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  • The test was also conducted on six children with known urea-cycle disorders, including five with ornithine transcarbamylase deficiency.

    • Main Results:

    • Peak urinary orotic acid levels in healthy children and adolescents ranged from 9.3 to 13.0 mumol/mmol creatinine across age groups.
    • The mean peak orotic acid level in all healthy children tested was 3.1 +/- 2.7 mumol/mmol creatinine.
    • Children with urea-cycle disorders, particularly ornithine transcarbamylase deficiency, showed significantly elevated urinary orotic acid levels (26-134 mumol/mmol creatinine) after allopurinol administration.

    Conclusions:

    • The allopurinol challenge test provides valuable reference ranges for urinary orotic acid excretion in pediatric populations.
    • This test is effective in detecting elevated orotic acid levels indicative of urea-cycle disorders, aiding in their diagnosis.