Elevated levels of circulating amino acids and ammonia have been documented in patients with Reye's syndrome (RS). These elevated levels previously have been used to prognosticate peak neurologic involvement in RS, since total amino acid levels are higher in nonsurvivors1.2 and blood ammonia levels above 270 or 300 μg/dL are generally associated with poor patient prognosis.3.4
Although both tests are used for prognosticating peak neurologic involvement in RS, amino acid and ammonia determinations are of limited use. Six to 12 hours are required to quantitate total amino acid levels by automated analysis. Such delays are unacceptable because institution of aggressive therapy as early as possible is important for patients who may neurologically deteriorate. Blood ammonia determinations are complicated by the potential contamination of glassware and reagents by environmental ammonia, and most procedures require several milliliters of blood.5 This study evaluates the use of amino acid nitrogen
MCARTHUR BS, ARCINUE EL, SCHULTZ GE. Total α-Amino Acid Nitrogen Quantification as Prognosticator in Reye's Syndrome. Am J Dis Child. 1981;135(8):765–766. doi:10.1001/archpedi.1981.02130320073024
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