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[ARTEFACTS AND PITFALLS]: PHARMACEUTICAL PRODUCTS, INTERFERENCE IN AMINOACID AND ORGANIC ACID ANALYSIS [EXTERNAL]

[ARTEFACTS AND PITFALLS]: PHARMACEUTICAL PRODUCTS, INTERFERENCE IN AMINOACID AND ORGANIC ACID ANALYSIS [EXTERNAL]
Pitfalls in aminoacid and organic acid analysis and skin biopsy due to
1) metabolites of dietary origin (homocitrulline, anserine, arnosine,methylhistidine, furoyl compounds, adipic acid, dicarboxylic acids (MCT)
2) medications and additives (ampicillin, cephalosporines, valproate, pivalic acid, 2,3-butanediol from ethanol, cyclohexandio, 3-hydroxyisovaleric acid under long-term therapy with anticonvulsants, e.g. phenytoin, vigabatrin, carbamazepine, topiramate, sedation with 4-hydroxybuturic acid, 5-oxoproline under acetaminophen therapy)
3) bacterial overgrowth (D-lactate, cresol, 4-hydroxyphenylacetate, 4-cyclohexanecarboxylate, tyramine, hippuric acid, 3-hydroxypropionate, glutaric acid
4) intoxication (butanone in +ƒ-ketothiolase deficiency/neel polish remover)
5) skin-contamination with ointment (glycerol), prilocaine-lidocaine emulsion (EMLA) -> pseudo-lysosomal storage disease
6) Glycerol is widely used in the food industry as a sweetener (E422) and humectant in pharmaceutical formulations
7) gamma-Hyroxybutyric acid (GHB) is a naturally occurring neurotransmitter and a ppsychoactive drug (club drug or date rape)
Laboratory findings    2,3-Butanediol inc (urine)
    2-Aminoadipic acid inc (urine)
    3-Hydroxyisovaleric acid inc (urine)
    3-Hydroxypropionic acid inc (urine)
    3-Methylcrotonylglycine inc (urine)
    4-Aminobutyric acid inc (urine)
    4-Hydroxybutyric acid inc (serum)
    Alanine inc (plasma)
    Cyclohexandiol inc (urine)
    Glycerol inc (urine)
    Glycine inc (urine)
    Homocysteine inc (plasma)
    Lactate/Pyruvate ratio inc (blood)
    Methylcitric acid inc (urine)
    Thiamine pyrophosphate inc (urine)
Symptoms    
    Amino acids, plasma
    Amino acids, urine
    onset, adolescent
    onset, childhood
    onset, infancy
    Organic acids, urine
    skin biopsy, abnormal