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Clinical Chemistry 43: 158-161, 1997;
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(Clinical Chemistry. 1997;43:158-161.)
© 1997 American Association for Clinical Chemistry, Inc.

Articles

Measurement of lactate in cerebrospinal fluid in investigation of inherited metabolic disease

Andrew Hutchessona, Mary Anne Preece, George Gray and Anne Green

Department of Clinical Chemistry, The Children's Hospital, Ladywood Middleway, Birmingham B16 8ET, UK.
a Address correspondence to this author, at: Department of Clinical Chemistry, Bolton General Hospital, Minerva Rd., Farnworth, Bolton BL4 0JR, UK. Fax (44)1204 390791.

Measurement of lactate concentrations in cerebrospinal fluid (CSF) has been suggested as part of the investigation of inborn errors of the electron transport chain, but little information exists regarding the reference range in children or the relationship between CSF and plasma concentrations. In 39 children without bacterial meningitis, diabetes, or recent seizures, we determined that the median (range) lactate concentrations in CSF and plasma collected concurrently were 1.4 (0.8–2.2) and 1.5 (0.6–2.3) mmol/L; the regression equation was CSF lactate = (0.38 ± 0.06) plasma lactate + 0.83 (r2 = 0.14). In 8 of 11 (73%) children with electron transport chain defects, CSF lactate was >=3.0 mmol/L; however, 2 of these 8 had a normal plasma lactate concentration. CSF lactate was also increased in 2 children with nonketotic hyperglycinemia. The finding that CSF lactate concentrations may be increased despite a normal plasma lactate value in children with electron transport chain defects is an important clue to the diagnosis of these disorders.


Key Words: indexing terms: heritable disorders • pediatric chemistry • electron transport chain defects • hyperglycinemia • mitochondria




The following articles in journals at HighWire Press have cited this article:


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 Arch. Dis. Child.Home page
S L Chow, Z J Rooney, M A Cleary, P T Clayton, and J V Leonard
The significance of elevated CSF lactate
Arch. Dis. Child., November 1, 2005; 90(11): 1188 - 1189.
[Abstract] [Full Text] [PDF]

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 Clin. Chem.Home page
J.-F. Benoist, C. Alberti, S. Leclercq, O. Rigal, R. Jean-Louis, H. Ogier de Baulny, D. Porquet, and D. Biou
Cerebrospinal Fluid Lactate and Pyruvate Concentrations and Their Ratio in Children: Age-related Reference Intervals
Clin. Chem., March 1, 2003; 49(3): 487 - 494.
[Abstract] [Full Text] [PDF]

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 J. Neurol. Neurosurg. PsychiatryHome page
R G F Gray, M A Preece, S H Green, W Whitehouse, J Winer, and A Green
Inborn errors of metabolism as a cause of neurological disease in adults: an approach to investigation
J. Neurol. Neurosurg. Psychiatry, July 1, 2000; 69(1): 5 - 12.
[Full Text] [PDF]

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 Arch. Dis. Child.Home page
A C J HUTCHESSON
Clinical and laboratory findings in referrals for mitochondrial DNA analysis
Arch. Dis. Child., April 1, 1999; 80(4): 398a - 398.
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