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BY J. C. CRAWHALL, ELISABETH P. SAUNDERS AND C. J. THOMPSON Medical Professorial Unit, St Bartholomewâs Hospital, London The underlying genetic defect which gives rise to the clinical condition of homozygous cystinuria (cystine-lysinuria) is still unknown. It has been shown that there is a common but variable defect in the transport of cystine, lysine, arginine (Dent & Rose, 1951) and ornithine (Stein, 1951). Frimpter (1961) has demonstrated that an additional disulphide, cysteine-homocysteine disulphide, is also excreted in this disease. Frimpter et al. (1962) have also reported one patient in whom the cystine clearance was 2× the inulin clearance, suggesting that some tubular secretion of cystine was taking place. Frimpter (1963) has also shown by measurement of plasma arterial-venous differences in the kidney of a cystinuric patient that cystine reabsorption was apparently normal while cysteine reabsorption was deficient. Abnormalities of amino acid transport have also been demonstrated in the gut of cystinurics in vivo (Milne, Asatoor, Edwards & Loughridge, 1961) and in vitro (Thier, Fox, Segal & Rosenberg, 1964; McCarthy et al. 1964). It was thought that investigation of heterozygotes for the disease might throw further light on the nature of the abnormality and the mode of inheritance. Extensive
Annals of Human Genetics – Wiley
Published: Mar 1, 1966
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