Observations on the aminoaciduria in megaloblastic anaemia.

An abnormal excretion of amino-acids in the urine of patients with Addisonian pernicious anaemia in relapse has been reported by Weaver and Neill (1954), by Keeley and Politzer (1956), and by Crane, Hayes, and de Gruchy (1958). Weaver and Neill (1954) stated that in five patients there was an abnormal excretion of taurine with some over-excretion of lysine, cystine, and leucine, while in another with subacute combined degeneration of the spinal cord with no anaemia there was an abnormal excretion of taurine. Keeley and Politzer (1956) confirmed these findings in two patients with Addisonian pernicious anaemia and reported that in seven African patients with non-Addisonian megaloblastic anaemia the urinary amino-acid patterns were normal. On the other hand, Crane et al. (1958), after investigating nine patients with untreated Addisonian pernicious anaemia of whom two had subacute combined degeneration of the spinal cord, concluded that although amino-aciduria did occur there was no characteristic urinary amino-acid pattern in these patients. Moreover, one patient with subacute combined degeneration of the spinal cord showed no abnormal amino-acid excretion. They reported an increased excretion of taurine and f8-amino-iso-butyric acid (BAIB) in about half of their patients, and abnormal traces of aspartic acid, leucine, lysine, phenylalanine, tyrosine, and valine were also present. All three groups of investigators employed paper chromatographic techniques and studied urines only. The present report describes the results of an investigation of the urinary and plasma amino-acid patterns in a comparatively large series of patients with Addisonian pernicious anaemia and other megaloblastic anaemias. An attempt was made to determine the incidence and extent of the amino-aciduria; the consistency of the abnormal