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Die Enzymausscheidung im Urin

I. Unter normalen und pathologischen Bedingungen im Kindesalter

Urinary enzyme excretion

I. In normal and disease states during childhood

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Abstract

The determination of serum enzyme levels has been increasingly used in diagnosis of children's diseases. However, urinary enzymes have been little studied and many problems remain to be elucidated.

As a possible guide to differential diagnosis and prognosis of children's diseases, the urinary enzyme levels were determined in 350 children with and without diseases.

The urinary levels of lysozyme (MG=14,000), amylase (MG=45,000), alkaline phosphatase (AP, MG=100,000), glutamate transaminase (GOT, MG=100,000–120,000), lactic dehydrogenase (LDH, MG=140,000), leucine aminopeptidase (LAP, MG=300,000) and β-glucuronidase (MG=300,000) were measured simultaneously in each child.

In the neonatal period the highest activities of alkaline phosphatase, glutamate transaminase and lysozyme were observed on the first and second day after birth.

The urinary levels of alkaline phosphatase, glutamate transaminase and lactic dehydrogenase were elevated in more than half of the cases in the acute phase of glomerulonephritis, and gradually decreased down to normal levels during recovery.

High levels of alkaline phosphatase, glutamate transaminase, lactic dehydrogenase and β-glucoronidase were found in some cases of orthostatic proteinuria. In nephrosis, however, the enzyme activities were mainly low. Abnormally high enzyme levels were observed in leukemia, neuroblastoma, pneumonia, hyperthyreoidism, hyperbilirubinemia, bronchial asthma, and diabetes mellitus.

No correlation was found between the enzyme activities in the urine and serum.

Zusammenfassung

Wir haben im Urin von insgesamt 350 gesunden und kranken Kindern die Aktivität von 7 Enzymen und deren Isoenzymeigenschaften untersucht.

Bei Neugeborenen ist die höchste Aktivität der alkalischen Phosphatase, der Glutamin-Oxalacetat-Transaminase und des Lysozyms am 1. und 2. Tag nach der Geburt nachzuweisen.

Bei mehr als der Hälfte der Kinder mit akuter Glomerulonephritis sind die Aktivitäten der alkalischen Phosphatase, der Glutamin-Oxalacetat-Transaminase und der Lactat-Dehydrogenase pathologisch erhöht und gehen im Heilungsstadium allmählich auf normale Werte zurück.

Auch bei orthostatischer Proteinurie sind die Aktivitäten für diese Fermente sowie für β-Glucuronidase erhöht. Demgegenüber sind bei Kindern mit nephrotischem Syndrom die Fermentaktivitäten meistens tiefer.

Pathologisch erhöhte Enzymaktivitäten bestehen ferner bei Kindern mit Leukämie, Neuroblastom, Pneumonie, Hyperthyreoidismus, Hyperbilirubinämie, Asthma bronchiale und Diabetes mellitis.

Zwischen den Aktivitäten eines bestimmten Ferment im Urin und im Serum besteht keine Korrelation.

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Miyao, M., Hasegawa, Y., Kochi, T. et al. Die Enzymausscheidung im Urin. Z. Kinder-Heilk. 112, 113–123 (1972). https://doi.org/10.1007/BF00443498

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