Document Detail

[13C]Methionine breath test to assess intestinal failure-associated liver disease.
MedLine Citation:
PMID:  20581744     Owner:  NLM     Status:  MEDLINE    
Oxidation of L[1-C]methionine ([C]-Met) in liver mitochondria can be quantified by measuring exhaled CO2. We hypothesized that CO2 recovery after i.v. administered [C]-Met would provide a noninvasive measure of liver function in pediatric intestinal failure-associated liver disease (IFALD). After Institutional Review Board (IRB) approval, 27 patients underwent L[1-C]-Met breath tests ([C]-MBTs), five of whom underwent repeat testing after clinical changes in liver function. Sterile, pyrogen-free [C]-Met was given i.v. Six breath samples collected during 120 min were analyzed for CO2 enrichment using isotope ratio mass spectrometry. Pediatric end-stage liver disease (PELD) scores were recorded, and total carbon dioxide (CO2) production was measured by indirect calorimetry. Twenty-seven patients (median age = 5.3 mo) underwent a total of 34 [C]-MBTs without adverse events. Fourteen patients had documented liver biopsies (five with cirrhosis and nine with cholestasis or fibrosis). The [C]-MBT differentiated patients with and without cirrhosis (medians 210 and 350, respectively, p = 0.04). Serial [C]-MBTs in five patients reflected changing PELD scores. i.v. administering the stable isotope [C]-Met with serial breath sampling provides a useful, safe, and potentially clinically relevant evaluation of hepatic function in pediatric IFALD. The [C]-MBT may also help quantify progression or improvement of IFALD.
Debora Duro; Shimae Fitzgibbons; Clarissa Valim; Chi-Fu Jeffrey Yang; David Zurakowski; Melanie Dolan; Lori Bechard; Yong Ming Yu; Christopher Duggan; Tom Jaksic
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric research     Volume:  68     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-11     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  349-54     Citation Subset:  IM    
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MeSH Terms
Breath Tests*
Calorimetry, Indirect
Carbon Dioxide / metabolism*
Carbon Isotopes / administration & dosage,  diagnostic use*
Feasibility Studies
Injections, Intravenous
Intestinal Diseases / complications*
Liver / metabolism*,  pathology
Liver Diseases / diagnosis*,  etiology,  metabolism
Liver Function Tests*
Mass Spectrometry
Methionine / administration & dosage,  diagnostic use*
Mitochondria, Liver / metabolism
Predictive Value of Tests
Time Factors
Grant Support
#P30 DK40561-13/DK/NIDDK NIH HHS; #P30DK040561/DK/NIDDK NIH HHS; K24 HD058795/HD/NICHD NIH HHS; P30 DK040561/DK/NIDDK NIH HHS; P30 DK040561-14/DK/NIDDK NIH HHS; T32-HD43034-05A1/HD/NICHD NIH HHS
Reg. No./Substance:
0/Carbon Isotopes; 142M471B3J/Carbon Dioxide; AE28F7PNPL/Methionine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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