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Howard C. Hopps, M.D.
JAMA. 1945;129(2):151. doi:10.1001/jama.1945.02860360053027.
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To the Editor:—  In the note "Fatality Associated with the Administration of Amino Acid Digest" by Curreri, Hibma and Cohen (The Journal, July 7) it is stated that "to our Knowledge, no mortality has been previously recorded with the use of amino acids."I wish to call attention to the paper by Hopps and Campbell, "Immunologic and Toxic Properties of Casein Digest as Prepared for Parenteral Administration" (J. Lab. & Clin. Med.28:1203 [July] 1943), in which is reported a death one hour after the administration of 200 cc. of 10 per cent amino acid solution (hydrolyzed casein). At necropsy it was determined that this patient had severe hepatic damage. The mechanism of this untoward reaction to amino acids was discussed and it was concluded that in patients with severe hepatic damage (e. g. acute toxic necrosis or diffuse hepatitis) parenteral therapy with amino acids might result in sudden


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