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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2002;22:1046.)
© 2002 American Heart Association, Inc.

Special Article

Adverse Event Associated With Methionine Loading Test

A Case Report

E.M. Cottington; Christian LaMantia; Sally P. Stabler; Robert H. Allen; Albert Tangerman; Conrad Wagner; Steven H. Zeisel; S. Harvey Mudd

From Case Western Reserve University (E.M.C., C.L.), Cleveland, Ohio; the Division of Hematology (S.P.S., R.H.A.), University of Colorado Health Sciences Center, Denver; the Division of Gastroenterology and Hepatology (A.T.), University Medical Center Nijmegen, Nijmegen, the Netherlands; the Department of Biochemistry (C.W.), Vanderbilt University and the Department of Veteran’s Affairs Medical Center, Nashville, Tenn; the Department of Nutrition (S.H.Z.), School of Public Health and School of Medicine, University of North Carolina, Chapel Hill; and the Laboratory of Molecular Biology (S.H.M.), National Institute of Mental Health, Bethesda, Md.

Correspondence to S. Harvey Mudd, MD, NIMH/DIRP/LMB, Bldg 36, Room 1B-08, 36 Convent Dr MSC 4034, Bethesda, MD 20892-4034. E-mail shm{at}codon.nih.gov

Abstract

Abstract— The death of a control subject after an oral load of methionine for a study of the possible relationship between homocysteine and Alzheimer’s disease is reported. The subject developed postload plasma concentrations of methionine far beyond those reported previously in humans given the usual oral loading dose of methionine (100 mg/kg body wt). Her preload plasma metabolite values rule out known genetic diseases that might predispose one to unusually high methionine concentrations. The most likely explanation for these events is that the subject received a substantial overdose of methionine. The possibility that extremely high methionine concentrations may lead to severe cerebral effects is discussed, and it is recommended that any move to increase the sensitivity of the usual methionine loading test by increasing the dose of methionine either not be undertaken or be taken only with extreme care.

Key Words: methionine load elevation • cerebral death

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