Hyper-beta-alaninemia associated with beta-aminoaciduria and gamma-aminobutyricaciduria, somnolence and seizures

N Engl J Med. 1966 Mar 24;274(12):635-43. doi: 10.1056/NEJM196603242741201.

Abstract

Hyper-beta-alaninemia was found in a somnolent, convulsing infant. Hyper-beta-aminoaciduria (beta-ala, betaAIB and taurine) was also observed, varying directly with plasma beta-alanine concentration. The beta-aminoaciduria is explained by the interaction between beta-alanine and a specific cellular-transport system with preference for beta-amino compounds. Gamma-aminobutyricaciduria was also observed, its excretion being independent of beta-alanine levels. Dietary modifications, pyridoxine, pantothenic acid and antibiotic therapy were not beneficial. Post-mortem tissues had elevated levels of beta-alanine and carnosine; GABA levels in brain were probably elevated for the age of the patient. A proposed block in beta-alanine-alpha-ketoglutarate transaminase would expand the free beta-alanine pool, thus increasing tissue carnosine. beta-Alanine is a central-nervous-system depressant. Associated inhibition of GABA transaminase and displacement of GABA from central-nervous-system binding sites would produce GABAuria and convulsions.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 4-Aminobutyrate Transaminase / metabolism
  • Amino Acid Metabolism, Inborn Errors* / complications
  • Amino Acid Metabolism, Inborn Errors* / metabolism
  • Amino Acid Metabolism, Inborn Errors* / therapy
  • Disorders of Excessive Somnolence / etiology
  • Humans
  • Infant
  • Male
  • Seizures / etiology
  • Taurine / urine
  • beta-Alanine / blood*
  • beta-Alanine / metabolism
  • beta-Alanine / urine
  • gamma-Aminobutyric Acid / metabolism

Substances

  • beta-Alanine
  • Taurine
  • gamma-Aminobutyric Acid
  • 4-Aminobutyrate Transaminase