JAMAICAN VOMITING SICKNESS - BIOCHEMICAL INVESTIGATION OF 2 CASES

Methylenecycloprophylacetic acid, a known metabolite of hypoglycin A, was identified in the urine of 2 patients with Jamaican vomiting sickness. Excretion of unusual dicarboxylic acids such as 2-ethylmalonic, 2-methylsuccinic, glutaric, adipic and dicarboxylic acids with 8 and 10 C chains were also detected in both patients. The amounts of these dicarboxylic acids were 70-1000 times higher than normal. These metabolites have also been identified in urine of hypoglycin-treated rats. This evidence links hypoglycin A to Jamaican vomiting sickness as its causative agent. Urinary excretion of short-chain fatty acids was also increased up to 300 times higher than normal. Despite their clinical and histologic similarities, the cause and biochemical mechanisms of Jamaican vomiting sickness probably differ distinctly from those of Reye''s syndrome in which these abnormal urinary metabolites are not appreciably increased.