[Evaluation of a rapid diagnosis of congenital lactic acidemia by transported peripheral blood samples]

The usefulness of a rapid diagnosis of congenital lactic acidemia was investigated using peripheral blood samples from 40 patients with lactic acidemia which had been transported from the hospitals in every part of Japan. Platelets and monocytes were separated, and the rates of decarboxylation of pyruvate and activities of enzymes involved in pyruvate metabolism were measured. The activity of phosphoenolpyruvate carboxykinase in monocytes was relatively stable. However, [1-14C] pyruvate and [3-14C] pyruvate decarboxylation rates and cytochrome c oxidase activity in platelets and pyruvate carboxylase activity in monocytes were unstable and decreased during the transportation of blood samples. Therefore, in order to diagnose the enzyme defects, it was necessary to compare the values for patients with those for control subjects who were simultaneously examined. Using this method, a patient with pyruvate dehydrogenase complex deficiency was found in the 40 patients with congenital lactic acidemia.