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Biogenic amine status in acute fulminant hepatocellular failure in children
M S Krishnamoorthy1, N Sundaravalli, S Soundar
1Department of Pharmacology & Environmental Toxicology, Dr. A.L.M. P.G. Institute of Basic Medical Sciences, Taramani, Madras.
Insights
Biogenic amine levels in children with acute fulminant hepatocellular failure (AFHF) change predictably. Monitoring these levels, including 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA), can help manage AFHF and predict patient outcomes.
Area of Science:
- Pediatric Hepatology
- Neurochemistry
- Clinical Biochemistry
Background:
- Acute fulminant hepatocellular failure (AFHF) is a critical condition in children.
- Biogenic amines play crucial roles in neurological function and are implicated in various diseases.
- Understanding their metabolic changes in AFHF is essential for prognosis.
Purpose of the Study:
- To investigate the changes in biogenic amine status in pediatric patients with AFHF.
- To evaluate the potential of these biochemical markers in monitoring disease progression and recovery.
- To assess the utility of biogenic amine assays for predicting outcomes in AFHF.
Main Methods:
- Studied biogenic amine levels (CSF 5-HT, 5-HIAA, HVA; blood 5-HT, 5-HIAA; urinary 5-HIAA, MHPG, VMA) in pediatric AFHF cases.
- Measurements were taken at admission, during therapy, and upon recovery in responders.
- Compared amine levels to control values.
Main Results:
- Cerebrospinal fluid (CSF) and blood 5-hydroxyindoleacetic acid (5-HIAA) and CSF homovanillic acid (HVA) increased from precoma to coma and normalized upon recovery.
- Urinary 3-methoxy-4-hydroxyphenyl glycol (MHPG) and 3-methoxy-4-hydroxymandelic acid (VMA) decreased during precoma and coma, returning towards control levels at recovery.
- Distinct patterns were observed for different biogenic amine metabolites.
Conclusions:
- Biogenic amine profiles, particularly 5-HIAA and HVA, show dynamic changes during AFHF.
- Assaying these parameters can aid in monitoring AFHF patients during treatment.
- These biochemical markers may offer valuable prognostic information for pediatric AFHF cases.
Abstract:
This study involved pediatric cases with Acute fulminant hepatocellular failure (AFHF) put on conventional therapy at the Hospital for children, Madras. In these cases, the biogenic amine status was studied at the time of admission, during therapy and at the time of recovery in responders. The CSF 5-HT, 5-hydroxyindoleacetic acid (5-HIAA) and Homovanillic acid (HVA), blood 5-HT and 5-HIAA, and urinary 5-HIAA followed almost a similar pattern of changes during the course of AFHF: increase at precoma, further increase at coma, return towards control at recovery. In striking contrast, urinary 3-methoxy-4-hydroxyphenyl glycol (MHPG) and 3-methoxy-4-hydroxymandelic acid (VMA) registered a decrease at precoma, a further fall at coma and a value closer to control at recovery. The results suggest the usefulness of assay of these parameters in monitoring cases of AFHF during therapy and in offering prognosis for these cases.