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Clinical Pediatrics
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Fatal Carnitine Palmitoyltransferase II Deficiency in a Newborn: New Phenotpic Features

Maria R. Pierce, MD

Department of Pediatrics, Hayward Genetics Center

Gabriella Pridjian, MD

Departments of Pediatrics, Obstetrics and Gynecology, Human Genetics Program, Hayward Genetics Center; Tulane Medical School, Department of Ob/Gyn, Division of Maternal and Fetal Medicine SL11, 1430 Tulane Avenue, New Orleans, LA 70112

Sarah Morrison, MD

Arthur S. Pickoff, MD

Department of Pediatrics, Hayward Genetics Center

We describe the term male infant of asymptomatic, healthy nonconsanguineous parents presenting on the first day of life with nonketotic hypoglycemia, seizures, hepatomegaly, cardio-megaly with biventricular hypertrophy, and ventricular arrhythmias. Cranial ultrasound revealed cystic dysplasia with several foci of hyperechogenicity within the right basal ganglia. Free carnitine was markedly decreased in the urine and plasma with a pronounced elevation of plasma long-chain acylcarnitines. Fibroblast carnitine palmitoyltransferase II activity was reduced to 26% and 38% in the father and mother, respectively. The infant expired on day 5 of life from malignant ventricular tachy-arrhythmias. Diffuse lipid accumulation was evident at autopsy, including in the liver, heart, kidney, adrenal cortex, skeletal muscle, and lungs. This new case of infantile CPT-1I deficiency illustrates the severity of the early onset form of CPT-II deficiency.

Clinical Pediatrics, Vol. 38, No. 1, 13-20 (1999)
DOI: 10.1177/000992289903800102
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