This paper reports biochemical studies in a pregnant xanthinuric female (McKusick 27830) and compares the results with findings in three other xanthinurics studied by us, including a previously unreported female who had a nephrectomy for xanthine stones. The findings of raised levels of uric acid in plasma and urine at presentation in the third trimester of pregnancy, and the subsequent fall to almost undetectable levels 6 weeks post-partum, is regarded as evidence of the extent of fetal uric acid production and clearance by the maternal circulation.

A family of four siblings is reported. While both parents and one sib appear entirely normal, three other sibs give biochemical evidence of impaired potassium conservation, hypomagnesaemia and decreased urinary calcium output. Affected sibs may be symptom free and of either sex. The dominant clinical abnormality, when it does occur, is tetany and may be precipitated by non-specific illness. Sustained management of the hypokalaemia seems desirable.

A case of malignant hyperthermia is described. The possible occurrence of similar susceptibility among members of the patient's family was investigated by measuring their serum creatine phosphokinase activities. Patients who carry the trait have no presenting clinical stigmata and there is no specific screening test to detect its presence. The condition is more common than is generally believed. It is suggested that it would be worthwhile to reassess the diagnosis in patients who have died under anaesthesia from obscure causes, to consider the possibility that some of these may have been cases of malignant hyperthermia, and to study the serum creatine phosphokinase activities of their surviving relatives.

The rate of paracetamol absorption following oral administration has been used as a model of drug absorption and as an indirect estimate of the rate of gastric emptying before and after elective or emergency surgery in 13 adult patients. The rates of paracetamol absorption before and after surgery were not significantly different and compared well with results obtained previously in normal volunteers. This suggests that preoperative anxiety and pain did not delay gastric emptying in this group of patients.

No abstract