Increase in Guanidine-like Substance in Acute Liver Injury and Eclampsia. ∗

Abstract

A recent publication from this laboratory 1 reported an increase in guanidine or guanidine-like substances in the blood of dogs during the intoxication produced by carbon tetrachloride and chloroform. The increase in guanidine was soon followed by a marked fall in blood sugar which often reached levels of extreme hypoglycemia. Aside from these changes and a retention of bile pigments no marked abnormalities were noted in the blood chemistry. These intoxications were further characterized by nervous hyperexcitability, an followed by depressiond a gastro-intestinal irritation evidenced by vomiting, diarrhea, and frequent hemorrhages. The highly protective action of calcium salts in preventing and treating these intoxications has also been emphasized. 1 , 2 , 3

The outstanding pathological change produced by chloroform and by carbon tetrachloride, which was the drug chiefly studied, is a severe central necrosis of the liver. Although no definite relationship between the increase in guanidine and the liver damage has yet been demonstrated, it is natural to associate, at least tentatively, the disturbed metabolism with so conspicuous an injury. With this hypothesis in mind, it seems probable that when similar liver injury has been caused in some way other than by the administration of these drugs, similar abnormalities and symptoms may be looked for, and if present might also be relieved by calcium therapy.

Studies of an introductory nature have been made of the blood chemistry with special reference to guanidine and blood sugar levels in a few clinical cases representing various types of liver disease and also in cases of eclampsia—a condition which the majority of observers believe is accompanied by pathological changes in the liver. 1

Studies in Cases of Liver Disease. The guanidine was determined by the method of Major and Weber, 5 , 6 taking into consideration the possibility of interference due to creatine.