QUANTITATIVE ORGANIC-ACID ANALYSIS IN CEREBROSPINAL-FLUID AND PLASMA - REFERENCE VALUES IN A PEDIATRIC POPULATION

Quantitative reference values for the concentrations of organic acids in cerebrospinal fluid (CSF) and plasma, as well as ratios of individu al organic acids between CSF and plasma, were determined in twenty-thr ee pairs of samples from pediatric patients. Twenty-six organic acids were present and quantifiable in all or the majority of plasma and CSF specimens (limit of detection 1 mumol/l). There were substantial diff erences between subgroups of organic acids, best reflected by the rati os of individual acids between CSF and plasma. Metabolites related to fatty acid oxidation were present in CSF in substantially lower amount s than in plasma. Organic acids related to carbohydrate and energy met abolism and to amino acid degradation were present in CSF in equal or slightly lower amounts than in plasma. Finally, some organic acids wer e found in substantially higher amounts in CSF than in plasma, e.g. gl ycolate, glycerate, 2,4-dihydroxybutyrate, citrate and isocitrate. Qua ntitation of organic acids in CSF and plasma should aid diagnosis and monitoring of treatment of patients with organic acid disorders.