To the Editor: The work of Tanaka et al.1is of real interest. The demonstration of methylenecyclopropylacetic acid, the metabolite of hypoglycin A in the urine of patients with Jamaican vomiting sickness, establishes the toxic origin of that unusual disorder. The finding that the urine also contains large amounts of a variety of dicarboxylic acids contributes to an understanding of the mechanisms of the toxic effects of eating unripe akee. We were also interested in the elevations reported in the short-chain fatty acids in the serum and urine of these two patients. The authors have made the point that.Â .Â .
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