Summary
The central metabolism of dopamine, serotonin, cyclic AMP and cyclic GMP was studied by use of the probenecid test in three patients with bismuth encephalopathy and in one patient with mercury encephalopathy. The accumulation of HVA and of cGMP in the cerebrospinal fluid was depressed during the acute phase of bismuth encephalopathy with severe hyposomnia, while it was increased in a patient with regression of clinical symptoms and normal in a patient with more advanced recovery. The patient with chronic mercury poisoning showing a severe cerebellar ataxia and rigidity had an almost complete suppression of HVA accumulation and an increase of cGMP accumulation. No pronounced differences of 5-HIAA and cAMP behavior were found. It is concluded that the central metabolism of dopamine and of cGMP is severely affected in bismuth and mercury encephalopathies.
Zusammenfassung
Bei drei Patienten mit akuter Wismutenzephalopathie und einem Patienten mit chronischer Quecksilberenzephalopathie wurden die Monoaminmetaboliten Homovanillinsäure (HVS) und 5-Hydroxy-Indolessigsäure (5-HIES) sowie die zyklischen Nukleotide cAMP und cGMP im Liquor cerebrospinalis vor und nach Probenecid-Belastung bestimmt. Bei den Patienten mit Wismutenzephalopathie ergaben sich Hinweise auf Änderungen des Dopamin und des cGMP-Stoffwechsels in Korrelation zum klinischen Schweregrad. Der Anstieg von HVS und von cGMP war im akuten Stadium der schweren Hyposomnie gehemmt und bei einem Patienten in der Rückbildungsphase vermehrt. Bei dem Patienten mit chronischer Hg-Vergiftung war die Akkumulation von HVS fast völlig aufgehoben bei vermehrtem Anstieg von cGMP. Keine eindeutigen Änderungen waren im Verhalten des Serotoninmetaboliten 5-HIES und des cAMP erkennbar. Es wird geschlossen, daß bei Wismut und Quecksilberenzephalopathie der Stoffwechsel von Dopamin und von cGMP im Hirnstamm und im Kleinhirn gestört ist.
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Cramer, H., Renaud, B., Billiard, M. et al. Monoaminmetabolite und zyklische Nukleotide des Liquor cerebrospinalis bei Wismut- und Quecksilber-Encephalopathien. Arch. Psychiatr. Nervenkr. 226, 173–181 (1978). https://doi.org/10.1007/BF00341709
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DOI: https://doi.org/10.1007/BF00341709