L-methionine

Direct observations: clinical cases, poisoning incidents and other

Administrative data

Endpoint:

direct observations: clinical cases, poisoning incidents and other

Type of information:

experimental study

Adequacy of study:

supporting study

Reliability:

2 (reliable with restrictions)

Rationale for reliability incl. deficiencies:

other: Case report.

Data source

Reference

Reference Type:

publication

Title:

Adverse event associated with methionine loading test: a case report.

Author:

Cottington EM, LaMantia C, Stabler SP, Allen RH, Tangerman A, Wagner C, Zeisel SH, Mudd SH

Year:

2002

Bibliographic source:

Arterioscler Thromb Vasc Biol. 2002 Jun 1;22(6):1046-50.

Materials and methods

Study type:

clinical case study

Principles of method if other than guideline:

Case report regarding the death of a 69-year-old African American woman who was recruited and consented to participate in a study of methionine-homocysteine metabolism and its relationship to Alzheimer’s disease.

Test material

Test material information

Constituent 1

Reference substance name:

L-methionine

EC Number:

200-562-9

EC Name:

L-methionine

Cas Number:

63-68-3

Molecular formula:

C5H11NO2S

IUPAC Name:

L-methionine

Method

Subjects:

- Number of subjects exposed:
- Sex:female
- Age: 69 yeras
- Race: African American woman

Route of exposure:

oral

Reason of exposure:

intentional

Details on exposure:

intended dose: 100 mg/kg bw
Although there was no direct evidence that the dose of methionine received was incorrect, the blood analysis data are consistant with a dose approximately 10 times what was intended.

Results and discussion

Any other information on results incl. tables

After 2 h 40 min after the loading dose, the volunteer began to vomit and continued for several hours, during which prochlorperazine and diphenhydramine were given. At about 8 h after the methionine was given, she was taken to the emergency room, subsequently became apneic and pulseless, and was admitted to an intensive care unit. After various other complications, she died 30 d after the methionine load was administered. Retrospective measurements of plasma methionine showed it to be about 200 times the baseline value at 2 h after the dose, even higher at 4 h, and 10 times the baseline value after 2 d. Although there was no direct evidence that the dose of methionine was incorrect, the blood analysis data are consistent with a dose approximately 10 times what was intended (i.e.,∼70 times the dietary requirement).