On. Elpeleg et al., RECURRENT METABOLIC DECOMPENSATION IN PROFOUND CARNITINE PALMITOYLTRANSFERASE-II DEFICIENCY, The Journal of pediatrics, 122(6), 1993, pp. 917-919
A 3-year-old boy had recurrent episodes of lethargy, encephalopathy, a
nd hepatomegaly accompanied by hypoglycemia, elevated liver aminotrans
ferase and creatine kinase values, and nonketotic dicarboxylic aciduri
a; the serum carnitine level was moderately reduced. Carnitine palmito
yltransferase II activity was decreased in lymphocytes and fibroblasts
. Therapy with L-carnitine and a diet low in long-chain triglycerides
did not prevent recurrent episodes.