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Very long-chain acyl-CoA dehydrogenase deficiency in an infant presenting with massive hepatomegaly

R G Boles1

  • 1Division of Medical Genetics, Childrens Hospital Los Angeles, CA 90027, USA. rboles@chla.usc.edu

Insights

A 9-month-old boy with very long-chain acyl-CoA dehydrogenase deficiency (VLCAD) experienced hypotonia, cardiomyopathy, and liver enlargement after viral gastroenteritis. Early diagnosis and treatment led to a successful outcome.

Area of Science:

  • Biochemistry
  • Genetics
  • Pediatrics

Background:

  • Very long-chain acyl-CoA dehydrogenase deficiency (VLCAD) is an inherited metabolic disorder affecting fatty acid oxidation.
  • VLCAD deficiency can manifest with diverse clinical symptoms, including cardiomyopathy and hypotonia, particularly in infants.

Observation:

  • A 9-month-old male infant presented with generalized hypotonia, severe cardiomyopathy, and massive hepatomegaly.
  • These symptoms emerged following a 10-day history of viral gastroenteritis.

Findings:

  • The infant was diagnosed with very long-chain acyl-CoA dehydrogenase deficiency.
  • Genetic testing confirmed the diagnosis of VLCAD deficiency.

Implications:

  • This case highlights the importance of considering inborn errors of metabolism, such as VLCAD deficiency, in infants presenting with unexplained cardiomyopathy and hypotonia, especially after a viral illness.
  • Prompt diagnosis and appropriate management, including dietary modifications and supportive care, are crucial for successful treatment outcomes in VLCAD deficiency.
  • Early intervention can prevent severe complications and improve the long-term prognosis for affected children.

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