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Published on: June 25, 2010
Isovaleric Acidemia: A Rare Case of an Inborn Error of Metabolism
Adnan Khan1, Bakhtyar Zahid1, Sarbiland Khan2
1Pediatrics, Rehman Medical Institute, Peshawar, PAK.
Insights
Isovaleric acidemia (IVA), a leucine metabolism disorder, was diagnosed in an infant presenting with fever and respiratory distress. Prompt supportive care and metabolic correction were initiated for this rare genetic condition.
Area of Science:
- Biochemistry
- Genetics
- Pediatrics
Background:
- Isovaleric acidemia (IVA) is an inherited metabolic disorder affecting leucine breakdown.
- It results from a deficiency in the enzyme isovaleryl-CoA dehydrogenase (IVD).
- This deficiency leads to toxic metabolite accumulation.
Abstract:
Isovaleric acidemia (IVA) is an autosomal recessive disease of the leucine metabolism due to a deficiency of isovaleryl-CoA dehydrogenase (IVD). We report the case of a six-month-old girl admitted with a seven-day history of fever, cough, stridor, vomiting, and respiratory distress. Second-degree consanguinity was documented between the parents. Urine organic acid analysis by gas chromatography-mass spectrometry showed marked excretion of 3-hydroxybutyric acid along with moderate excretion of 3- hydroxy-isovaleric acid. Isovaleric acidemia was diagnosed based on history, examination, and laboratory evaluation. The patient managed with fluid resuscitation, correction of her metabolic acidosis, antibiotics, and supportive care.
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