TY - JOUR
T1 - Favorable outcome after physiologic dose of sodium-D,L-3-hydroxybutyrate in severe MADD
AU - Van Rijt, Willemijn J.
AU - Heiner-Fokkema, M. Rebecca
AU - Sarvaas, Gideon J. du Marchie
AU - Waterham, Hans R.
AU - Blokpoel, Robert G. T.
AU - van Spronsen, Francjan J.
AU - Derks, Terry G. J.
N1 - Copyright © 2014 by the American Academy of Pediatrics.
PY - 2014/10
Y1 - 2014/10
N2 - Multiple acyl coenzyme A dehydrogenase deficiency (MADD) is a severe inborn error of metabolism. Experiences with sodium-D,L-3-hydroxybutyrate (3-HB) treatment are limited although positive; however, the general view on outcome of severely affected patients with MADD is relatively pessimistic. Here we present an infant with MADD in whom the previously reported dose of 3-HB did not prevent the acute, severe, metabolic decompensation or progressive cardiomyopathy in the subsequent months. Only after a physiologic dose of 2600 mg/kg of 3-HB per day were ketone bodies detected in blood associated with improvement of the clinical course, N-terminal prohormone of brain natriuretic peptide and echocardiographic parameters. Long-term studies are warranted on 3-HB treatment in patients with MADD.
AB - Multiple acyl coenzyme A dehydrogenase deficiency (MADD) is a severe inborn error of metabolism. Experiences with sodium-D,L-3-hydroxybutyrate (3-HB) treatment are limited although positive; however, the general view on outcome of severely affected patients with MADD is relatively pessimistic. Here we present an infant with MADD in whom the previously reported dose of 3-HB did not prevent the acute, severe, metabolic decompensation or progressive cardiomyopathy in the subsequent months. Only after a physiologic dose of 2600 mg/kg of 3-HB per day were ketone bodies detected in blood associated with improvement of the clinical course, N-terminal prohormone of brain natriuretic peptide and echocardiographic parameters. Long-term studies are warranted on 3-HB treatment in patients with MADD.
KW - multiple acyl coenzyme A dehydrogenase deficiency
KW - mitochondrial fatty acid oxidation
KW - cardiomyopathy
KW - sodium-D,L-3-hydroxybutyrate
KW - COA-DEHYDROGENASE-DEFICIENCY
KW - TANDEM MASS-SPECTROMETRY
KW - CHILDREN
U2 - 10.1542/peds.2013-4254
DO - 10.1542/peds.2013-4254
M3 - Article
C2 - 25246622
SN - 0031-4005
VL - 134
SP - e1224-e1228
JO - Pediatrics
JF - Pediatrics
IS - 4
ER -