Journal of Inherited Metabolic Disease

, Volume 28, Issue 4, pp 467–472 | Cite as

Elevated plasma citrulline and arginine due to consumption of Citrullus vulgaris (watermelon)

  • H. Mandel
  • N. Levy
  • S. Izkovitch
  • S. H. Korman


A 19-month-old girl with developmental delay was found to have moderately elevated plasma citrulline and mildly elevated plasma arginine concentrations. Dietary history revealed that she consumed large quantities of watermelon (Citrullus vulgaris), a fruit containing high free citrulline and arginine concentrations. In order to determine whether the patient’s high watermelon intake could account for her elevated plasma citrulline and arginine concentrations, we studied the response of plasma citrulline and arginine to ingestion of watermelon in six healthy adult volunteers. All developed markedly elevated plasma citrulline (mean maximum 593 μmol/L, range 386–1069) and moderately elevated plasma arginine (mean maximum 199 μmol/L, range 128–251). Physicians and laboratory personnel performing metabolic investigations should be aware of watermelon-induced citrullinaemia. Its hallmarks are elevated plasma citrulline, and to a lesser extent arginine, in the absence of orotic or arginosuccinic aciduria or hyperammonaemia. This phenomenon has implications for the management of patients with urea cycle and related disorders.


Public Health Internal Medicine Urea Arginine Metabolic Disease 
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Copyright information

© SSIEM and Springer 2005

Authors and Affiliations

  • H. Mandel
    • 1
  • N. Levy
    • 2
  • S. Izkovitch
    • 3
  • S. H. Korman
    • 4
    • 5
  1. 1.Metabolic UnitHaifa
  2. 2.Department of Clinical NutritionMeyer Children’s HospitalHaifa
  3. 3.Department of Clinical Biochemistry, Rambam Medical Center, Bruce Rappaport Faculty of MedicineTechnion-Israel Institute of TechnologyHaifa
  4. 4.Department of Clinical BiochemistryHadassah – Hebrew University Medical CenterJerusalemIsrael
  5. 5.Department of Clinical BiochemistryHadassah University HospitalJerusalemIsrael

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