Skip to main content
Log in

Acylcarnitines in plasma and blood spots of patients with long-chain 3-hydroxyacyl-coenzyme A dehydrogenase defiency

  • Published:
Journal of Inherited Metabolic Disease

Abstract

The acylcarnitines in plasma and blood spots of 23 patients with proven deficiency of long-chain 3-hydroxyacylcoenzyme A dehydrogenase were reviewed. Long-chain 3-hydroxyacylcarnitines of C14:1, C14, C16 and C18:1 chain length, and long-chain acylcarnitines of C12, C14:1, C14, C16, C18:2 and C18:1 chain length were elevated. Acetylcarnitine was decreased. In plasma, elevation of hydroxy-C18:1 acylcarnitine over the 95th centile of controls, in combination with an elevation of two of the three acylcarnitines C14, C14:1 and hydroxy-C16, identified over 85% of patients with high specificity (less than 0.1% false positive rate). High endogenous levels of long-chain acylcarnitines in normal erythrocytes reduced the diagnostic specificity in blood spots compared with plasma samples. The results were also diagnostic in asymptomatic patients, and were not influenced by genotype. Treatment with diet low in fat and high in medium-chain triglyceride decreased all disease-specific acylcarnitines, often to normal, suggesting that this assay is useful in treatment monitoring.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Bohmer T, Behmer J (1958) Propionylcarnitine, physiological variations in vivo. Biochim Biophys Acta 152: 559–567.

    Google Scholar 

  • Chace DH, Millington DS, Terada N, Kahler SG, Roe CR, Hofman LF (1993) Rapid diagnosis of phenylketonuria by quantitative analysis of phenylalanine and tyrosine in neonatal blood spots by tandem mass spectrometry. Clin Chem 39: 66–71.

    PubMed  Google Scholar 

  • Chace DH, Hillman SL, Van Hove JLK, Naylor EW(1997) Rapid diagnosis of MCAD de¢ciency: quan-titative analysis of octanoylcarnitine and other acylcarnitines in newborn blood spots by tandem mass spectrometry. Clin Chem 43: 2106–2113.

    PubMed  Google Scholar 

  • Costa CG, Dorland L, Holwerda U, et al (1998) Simultaneous analysis of plasma free fatty acids and their 3-hydroxy analogs in fatty acid b-oxidation disorders. Clin Chem 44: 463–471.

  • Dionisi-Vici C, Burlina AB, Bertini E, et al (1991) Progressive neuropathy and recurrent myoglobinuria in a child with long-chain 3-hydroxyacyl-coenzyme A dehydrogenase de¢ciency. J Pediatr 118: 744–746.

  • Duran M, Wanders RJA, deJager JP, et al (1991) 3-Hydroxydicarboxylic aciduria due to long-chain 3-hydroxyacyl-coenzyme A dehydrogenase de¢ciency associated with sudden neonatal death: protective e¡ect of medium-chain triglyceride treatment. Eur J Pediatr 150: 190–195.

  • Hagenfeldt L, von Dobeln U, Holme E, et al (1990) 3-Hydroxydicarboxylic aciduriaöa fatty acid oxidation defect with severe prognosis. J Pediatr 116: 387–392.

  • Hale DE, Batshaw ML, Coates PM, et al (1985) Long-chain acyl-coenzyme A dehydrogenase de¢ciency: an inherited cause of nonketotic hypoglycemia. Pediatr Res 19: 666–671.

  • Ibdah JA, Bennett MJ, Rinaldo P, et al (1999) A fetal fatty-acid oxidation disorder as a cause of liver disease in pregnant woman. N Engl J Med340: 1723–1731.

  • Ijlst L, Ruiter JPN, Hoovers JMN, Jakobs ME, Wanders RJA (1996) Common missense mutation of G1528C in long-chain 3-hydroxyacyl-CoA dehydrogenase de¢ciency. J Clin Invest 98: 1028–1033.

    PubMed  Google Scholar 

  • Millington DS, Kodo N, Terada N, Roe D, Chace DH (1991) The analysis of diagnostic markers of genetic disorders in human blood and urine using tandem mass spectrometry with liquid secondary ion mass spectrometry. Int J Mass Spectrom Ion Processes 111: 211–228.

    Google Scholar 

  • Millington DS, Terada N, Chace DH, et al (1992) The role of tandem mass spectrometry in the diagnosis of fatty acid oxidation disorders. In: Coates PM, Tanaka K, eds. Progress in Clinical and Biological Research, 375: New Developments in Fatty Acid Oxidation,. New York: Wiley-Liss, 339–354.

  • Millington DS, Chace DH, Hillman SL, Kodo N, Terada N (1994) Diagnosis of metabolic disease. In: Matsuo T, Caprioli RM, Gross ML, Seyama Y, eds. Biological Mass Spectrometry: Present and Future. New York: Wiley, 559–579.

    Google Scholar 

  • Moore R, Glasgow JFT, Bingham MA, et al (1993) Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase de¢ciencyödiagnosis, plasma carnitine fractions and management in a further patient. Eur J Pediatr 152: 433–436.

  • Morris AAM, Shortland GJ, van Wyk K, et al (1998) Use of medium-chain triglyceride in long-chain 3-hydroxyacyl-CoA dehydrogenase de¢ciency. J Inherit Metab Dis 21(supplement 2): 3.

  • Pons R, Roig M, Riudor E, et al (1996) The clinical spectrum of long-chain 3-hydroxyacyl-CoA dehydrogenase de¢ciency. Pediatr Neurol 14: 236–243.

  • Rashed MS, Ozand PT, Bucknall MP, Little D (1995) Diagnosis of inborn errors of metabolism from blood spots by acylcarnitines and amino acids pro¢ling using automated electrospray tandem mass spectrometry. Pediatr Res 38: 342–331.

    PubMed  Google Scholar 

  • Roe CR, Coates PM (1995) Mitochondrial fatty acid oxidation disorders. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds. The Metabolic and Molecular Bases of Inherited Disease, 7th edn. New York: McGraw-Hill, 1501–1533.

    Google Scholar 

  • Schmidt-Sommerfeld E, Penn D, Duran M, Bennett MJ, Santer R, Stanley CA (1993) Detection of inborn errors of fatty acid oxidation from acylcarnitine analysis of plasma and blood spots with the radio-isotopic exchange-high-performance liquid chromatographic method. J Pediatr 122: 708–714.

    PubMed  Google Scholar 

  • Shen J-J, Matern D, Millington DS, et al (2000) Acylcarnitines in ¢broblasts with long-chain 3-hydroxyacylcoenzyme A dehydrogenase de¢ciency and other fatty acid oxidation disorders. J Inherit Metab Dis 23: 27–44.

  • Sims HF, Brackett JC, Powell CK, et al (1995) The molecular basis of pediatric long chain 3-hydroxyacyl-CoA dehydrogenase de¢ciency associated with maternal acute fatty liver of pregnancy. Proc Natl Acad Sci USA 92: 841–845.

  • Strauss AW, BennettMJ, Rinaldo P, et al (1999) Inherited long-chain 3-hydroxyacyl-CoA dehydrogenase de¢ciency and a fetal-maternal interaction cause maternal liver disease and other pregnancy complications. Semin Perinatol 23: 100–112.

  • Treem WR, Shoup ME, Hale DE, et al (1996) Acute fatty liver of pregnancy, hemolysis, elevated liver enzymes, and low platelets syndrome, and long chain 3-hydroxyacyl-coenzyme A dehydrogenase de¢ciency. Am J Gastroenterol 91: 2293–2300.

  • Tyni T, Paloti A, Vlinikka L, et al (1997) Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase de¢ciency with the G1528C mutation: clinical presentation of thirteen patients. J Pediatr 130 67–76.

  • Van Hove JLK, Zhang W, Kahler SG, et al (1993) Medium-chain acyl-CoA dehydrogenase (MCAD) de¢ciency: diagnosis by acylcarnitine analysis in blood. Am J Hum Genet 52: 958–966.

  • Venizelos N, Ijlst L, Wanders RJA, Hagenfeldt L (1994) b-Oxidation enzymes in ¢broblasts from patients with 3-hydroxydicarboxylic aciduria. Pediatr Res 36: 111–114.

    PubMed  Google Scholar 

  • Ventura FV, Costa CG, Struys EA, et al (1999) Quantitative acylcarnitine pro¢ling in ¢broblasts using [U-13C]palmitic acid: an improved tool for the diagnosis of fatty acid oxidation defects. Clin Chim Acta 281: 1–17.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Van Hove, J.L.K., Kahler, S.G., Feezor, M.D. et al. Acylcarnitines in plasma and blood spots of patients with long-chain 3-hydroxyacyl-coenzyme A dehydrogenase defiency. J Inherit Metab Dis 23, 571–582 (2000). https://doi.org/10.1023/A:1005673828469

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1005673828469

Keywords

Navigation