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Rare case of primary carnitine deficiency presenting as acute liver failure
  1. Shalu Jain,
  2. Karunesh Kumar,
  3. Smita Malhotra and
  4. Anupam Sibal
  1. Pediatric Gastroenterology, Indraprastha Apollo Hospital, New Delhi, India
  1. Correspondence to Dr Shalu Jain; shalu0927{at}


Systemic primary carnitine deficiency (PCD) is an autosomal recessive disorder caused by mutations in the SLC22A5 gene that encodes carnitine transporter, OCTN2. Transporter deficiency leads to defective fatty acid oxidation. Signs and symptoms ranging from liver injury in children to cardiomyopathy and skeletal myopathy in adults, manifest during periods of stress and fasting. Though acute liver failure is infrequently described, young children presenting as acute liver failure should be screened for fatty acid oxidation defects including PCD by testing plasma for amino acids and further confirmed by genetic sequencing. Early identification and treatment using L-carnitine is lifesaving. Our patient presented as acute liver failure and diagnosis of PCD was confirmed by metabolic screening and genetic sequencing. He responded to the treatment.

  • Paediatrics (drugs and medicines)
  • Liver disease
  • Genetics
  • Paediatrics

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  • Contributors SJ drafted the work. KK did the literature review. SM edited the work. AS gave the final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.