Skip to main content
Log in

Infant with hepatomegaly and hypoglycemia: A setting for fatty acid oxidation defects

  • Case report
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Fatty acid oxidation defects (FAOD) are one of the commonest metabolic liver diseases (MLDs) that can have varied presentations in different age groups. An infant presented with short history of jaundice and irritability, examination showed soft hepatomegaly. Investigations revealed non-ketotic hypoglycemia suggesting FAOD which was later confirmed as carnitine uptake defect with gas chromatography and mass spectrometry and mutation analysis. Patient improved with acute management of metabolic crisis, carnitine supplementation and corn starch therapy with reversal of encephalopathy, reduction in hepatomegaly, maintenance of euglycemia and improvement in liver function tests and creatine phosphokinase on follow up. Non-ketotic hypoglycemia is a characteristic finding in FAODs. Early diagnosis and appropriate management can result in excellent outcomes in patients with FAODs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Kerner J, Hoppel C. Genetic disorders of carnitine metabolism and their nutritional management. Annu Rev Nutr. 1998;18:179–206.

    Article  CAS  PubMed  Google Scholar 

  2. El-Hattab AW, Scaglia F. Disorders of carnitine biosynthesis and transport. Mol Genet Metab. 2015;116:107–12.

    Article  CAS  PubMed  Google Scholar 

  3. Frazier DM, Millington DS, McCandless SE, et al. The tandem mass spectrometry newborn screening experience in North Carolina: 1997-2005. J Inherit Metab Dis. 2006;29:76–85.

    Article  CAS  PubMed  Google Scholar 

  4. Wanders RJ, Ruiter JP, IJLst L, Waterham HR, Houten SM. The enzymology of mitochondrial fatty acid beta-oxidation and its application to follow-up analysis of positive neonatal screening results. J Inherit Metab Dis. 2010;33:479–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Baruteau J, Sachs P, Broué P, et al. Clinical and biological features at diagnosis in mitochondrial fatty acid beta-oxidation defects: a French pediatric study of 187 patients. J Inherit Metab Dis. 2013;36:795–803.

    Article  CAS  PubMed  Google Scholar 

  6. Bennet MJ. Pathophysiology of fatty acid oxidation disorders. J Inherit Metab Dis. 2010;33:533–7.

    Article  Google Scholar 

  7. Kompare M, Rizzo WB. Mitochondrial fatty-acid oxidation disorders. Semin Pediatr Neurol. 2008;15:140–9.

    Article  PubMed  Google Scholar 

  8. Spiekerkoetter U, Bastin J, Gillingham M, Morris A, Wijburg F, Wilcken B. Current issues regarding treatment of mitochondrial fatty acid oxidation disorders. J Inherit Metab Dis. 2010;33:555–61.

    Article  CAS  PubMed  Google Scholar 

  9. Spiekerkoetter U, Lindner M, Santer R, et al. Treatment recommendations in long-chain fatty acid oxidation defects: consensus from a workshop. J Inherit Metab Dis. 2009;32:498–505.

    Article  CAS  PubMed  Google Scholar 

  10. Lund AM, Skovby F, Vestergaard H, Christensen M, Christensen E. Clinical and biochemical monitoring of patients with fatty acid oxidation disorders. J Inherit Metab Dis. 2010;33:495–500.

    Article  CAS  PubMed  Google Scholar 

  11. Wilcken B. Fatty acid oxidation disorders: outcome and long-term prognosis. J Inherit Metab Dis. 2010;33:501–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anshu Srivastava.

Electronic supplementary material

Supplementary Table 1

(XLSX 4170 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ravindranath, A., Pai, G., Srivastava, A. et al. Infant with hepatomegaly and hypoglycemia: A setting for fatty acid oxidation defects. Indian J Gastroenterol 36, 429–434 (2017). https://doi.org/10.1007/s12664-017-0790-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12664-017-0790-0

Keywords

Navigation