I wish to thank Dr. Michael D. Innis for his kind remarks on July 9 re “Clemetson’s work.”
There seem to be few paediatricians who consider a capillary
fragility state as being responsible for retinal petechiae, and for
bleeding from the venules of the bridging veins, between the brain and the
dura mater, which could lead to a major subdural haemorrhage. All-or-
nothing phenomena are rare in physiology and in pathology, so we need to
consider degrees of weakness in these blood vessels. We see detailed
reports of blood coagulation studies in accusations of “shaken-baby-
syndrome”, but no reports of capillary fragility studies.
Plasma ascorbic acid and whole blood histamine analyses are
absolutely essential for anyone wishing to study capillary fragility in
these compromised infants. There is a big difference between blood
histamine levels, which can be toxic when dangerously high, and tissue
histamine sensitivities, which may be only local. No accusations of child-
abuse should ever be made without these simple blood tests to exclude
capillary fragility.
The blood histamine concentration increases in an exponential manner
as the plasma ascorbic acid level falls. There is a ten-fold increase in
the blood histamine concentration -- rising from 18 to 180 micrograms/L -
- when the plasma ascorbic acid level falls from 1.0 to 0.1 mg/100 mL,
even in apparently healthy, ambulant people. This elevated blood histamine
level, or histaminaemia, can rise to a toxic level during infection and/or
following the injection of foreign proteins.
No physician can accurately diagnose or treat infants suspected of
having been shaken, unless he or she understands the basic physiology of
capillary fragility and toxic histaminaemia.
C. Alan B. Clemetson, Professor Emeritus, Tulane University School of
Medicine, New Orleans, Louisiana, U.S.A.
References
1) Clemetson, C.A.B. Histamine and ascorbic acid in human blood. J
Nutr 1980;110:662-668.
2) Chatterjee, I.B., Majumder, A.K., Nandi, B.K., Subramanian, N.
Synthesis and some major functions of vitamin C in animals. Ann NY Acad
Sci 1975;258:24-47.
3) Kalokerinos, A. Every Second Child. Thomas Nelson (Australia)
Ltd.: Sydney, 1974. Also in Pivot Health Books: Every Second Child. Keats
Publishing, Inc.: New Canaan, CT, 1981.
4) King, C., Menten, M.L. The influence of vitamin C level upon
resistance to diphtheria toxin. J Nutr 1935;10:129-140.
5) Parrot, J.L., Richet, G. Accroissement de la sensibilité a
histamine chez le cobaye soumis a un régime scorbutogène. CR Soc Biol
1945;139:1072-1075.
6) Clemetson, C.A.B. Vaccinations, inoculations and ascorbic acid. J
Orthomol Med 1999;14:137-142.
7) Clemetson, C.A.B. Is it “Shaken Baby,” or a Barlow’s disease
variant? J Amer Phys Surg 2004; 9:78-80.
8) Clemetson, C.A.B. Elevated blood histamine caused by vaccinations
and vitamin C deficiency may mimic the shaken baby syndrome. Medical
Hypotheses 2004;62:533-536.
Competing interests:
None declared
Competing interests:
No competing interests
28 September 2004
C. Alan B. Clemetson, M.D.
Professor Emeritus
5844 Fontainebleau Drive, New Orleans, Louisiana 70125
Rapid Response:
Toxic histaminaemia
I wish to thank Dr. Michael D. Innis for his kind remarks on July 9 re “Clemetson’s work.”
There seem to be few paediatricians who consider a capillary
fragility state as being responsible for retinal petechiae, and for
bleeding from the venules of the bridging veins, between the brain and the
dura mater, which could lead to a major subdural haemorrhage. All-or-
nothing phenomena are rare in physiology and in pathology, so we need to
consider degrees of weakness in these blood vessels. We see detailed
reports of blood coagulation studies in accusations of “shaken-baby-
syndrome”, but no reports of capillary fragility studies.
Plasma ascorbic acid and whole blood histamine analyses are
absolutely essential for anyone wishing to study capillary fragility in
these compromised infants. There is a big difference between blood
histamine levels, which can be toxic when dangerously high, and tissue
histamine sensitivities, which may be only local. No accusations of child-
abuse should ever be made without these simple blood tests to exclude
capillary fragility.
The blood histamine concentration increases in an exponential manner
as the plasma ascorbic acid level falls. There is a ten-fold increase in
the blood histamine concentration -- rising from 18 to 180 micrograms/L -
- when the plasma ascorbic acid level falls from 1.0 to 0.1 mg/100 mL,
even in apparently healthy, ambulant people. This elevated blood histamine
level, or histaminaemia, can rise to a toxic level during infection and/or
following the injection of foreign proteins.
No physician can accurately diagnose or treat infants suspected of
having been shaken, unless he or she understands the basic physiology of
capillary fragility and toxic histaminaemia.
C. Alan B. Clemetson, Professor Emeritus, Tulane University School of
Medicine, New Orleans, Louisiana, U.S.A.
References
1) Clemetson, C.A.B. Histamine and ascorbic acid in human blood. J
Nutr 1980;110:662-668.
2) Chatterjee, I.B., Majumder, A.K., Nandi, B.K., Subramanian, N.
Synthesis and some major functions of vitamin C in animals. Ann NY Acad
Sci 1975;258:24-47.
3) Kalokerinos, A. Every Second Child. Thomas Nelson (Australia)
Ltd.: Sydney, 1974. Also in Pivot Health Books: Every Second Child. Keats
Publishing, Inc.: New Canaan, CT, 1981.
4) King, C., Menten, M.L. The influence of vitamin C level upon
resistance to diphtheria toxin. J Nutr 1935;10:129-140.
5) Parrot, J.L., Richet, G. Accroissement de la sensibilité a
histamine chez le cobaye soumis a un régime scorbutogène. CR Soc Biol
1945;139:1072-1075.
6) Clemetson, C.A.B. Vaccinations, inoculations and ascorbic acid. J
Orthomol Med 1999;14:137-142.
7) Clemetson, C.A.B. Is it “Shaken Baby,” or a Barlow’s disease
variant? J Amer Phys Surg 2004; 9:78-80.
8) Clemetson, C.A.B. Elevated blood histamine caused by vaccinations
and vitamin C deficiency may mimic the shaken baby syndrome. Medical
Hypotheses 2004;62:533-536.
Competing interests:
None declared
Competing interests: No competing interests