Inborn Errors of Metabolism

CE allows easy, rapid identification and quantitation of organic acids (see Chapter 10) such as methylmalonic, pyroglutamic, and glutaric acids in urine or serum. These organic acids can be increased owing to deficiency of enzymes in amino-acid metabolism (41). Methylmalonic acid can also be increased when there is a deficiency of folate or Vitamin B12.

CZE can also effectively separate purine bases and nucleosides, such as adenine, guanine, hypoxanthine, and uric acid from neonatal plasma (42). Deficiency of adenylosuccinate lyase in the purine metabolism pathway leads to accumulation of succinyladenosine and succinylaminoimidazole carboxamide riboside in body fluids that can be identified by CE (43).

3.12. Serum and Urine Analysis of Drugs

MEKC has been applied to therapeutic drug monitoring. Using MEKC theophylline and its analogues have been separated in plasma. In addition, it has been used to detect and quantitate serum levels of digoxin (44,45). MEKC can also efficiently separate and quantitate antiepileptic drugs that are used in combination, especially ethosuxamide, phenobarbitol, pheny-toin, and carbamazepine (46). (See Chapter 17 for a detailed discussion of the use of CE in therapeutic drug monitoring.) CE has also been used in the clinical and forensic arena (see Chapter 19). In these cases, the use of urine to identify intoxication and/or drug abuse of opiates, barbiturates, benzodi-azepines, stimulants, and doping screening is possible within a few minutes (47-51). It is also possible to use CE to screen post mortem fluids for illicit drugs or elevated levels of legal drugs (see Chapter 20). CE has also been applied to determine the tissue concentration of 5-Fluorouracil (5-Fl) in tumor and subcutaneous adipose tissue microdialysates from patients with primary breast cancer (52).

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