A Fatal Overdose of Arginine Hydrochloride

Gerard, James; Luisiri, Atchawee

doi:10.3109/15563659709001243

Cited by 19 publications

(7 citation statements)

References 12 publications

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“…Because l -arginine therapy is not free of side effects [18,28,29], it is important to clarify the exact mechanisms of l -arginine improvement to determine the potential implications regarding benefits, dosage and side effects. Several issues need more clarification.…”

Section: Resultsmentioning

confidence: 99%

Nitric Oxide Synthesis Is Increased in Cybrid Cells with m.3243A>G Mutation

Gamba

Rodrigues

et al. 2012

IJMS

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Nitric oxide (NO) is a free radical and a signaling molecule in several pathways, produced by nitric oxide synthase (NOS) from the conversion of l-arginine to citrulline. Supplementation of l-arginine has been used to treat MELAS (mitochondrial encephalopathy with lactic acidosis and stroke like syndrome), a mitochondrial disease caused by the m.3243A>G mutation. Low levels of serum arginine and endothelium dysfunction have been reported in MELAS and this treatment may increase NO in endothelial cells and promote vasodilation, decreasing cerebral ischemia and strokes. Although clinical benefits have been reported, little is known about NO synthesis in MELAS. In this study we found that osteosarcoma derived cybrid cells with high levels of m.3243A>G had increased nitrite, an NO metabolite, and increased intracellular NO, demonstrated by an NO fluorescent probe (DAF-FM). Muscle vessels from patients with the same mutation had increased staining in NADPH diaphorase, suggestive of increased NOS. These results indicate increased production of NO in cells harboring the m.3243A>G, however no nitrated protein was detected by Western blotting. Further studies are necessary to clarify the exact mechanisms of l-arginine effect to determine the appropriate clinical use of this drug therapy.

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Section: Resultsmentioning

confidence: 99%

Nitric Oxide Synthesis Is Increased in Cybrid Cells with m.3243A>G Mutation

Gamba

Rodrigues

et al. 2012

IJMS

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“…The concentration in group 1 in the current study was much higher, 4.2 mmol · l −1 , than the optimal concentrations in these studies (14, 15). L‐arginine in high doses may also be toxic as in a case report from Gerard and Luisiri (22), where a 21‐month‐old girl receiving 3.9 g · kg −1 of L‐arginine for 30 min, developed cardiopulmonary arrest. The concentration of arginine 5 h after the event was 1.3 mmol · l −1 .…”

Section: Discussionmentioning

confidence: 99%

No effect of L‐arginine supplementation on pulmonary endothelial dysfunction after cardiopulmonary bypass

Angdin

Settergren

Líška

et al. 2001

Acta Anaesthesiol Scand

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“…A 21-month-old girl with short stature who was inadvertently given 18.5 mmol/kg (3.9 g/kg; 300 mL of 10% arginine hydrochloride solution intravenously) as a bolus to measure growth hormone stimulation had a fatal reaction. 38 Within 30 minutes of the infusion she had gasping respiration and a cardiopulmonary arrest. She was re-suscitated but had suffered irreversible brain damage and died a few days later.…”

Section: S50mentioning

confidence: 99%