Abstract
Deficiency of long-chain 3-hydroxyacyl-coenzyme A (CoA) dehydrogenase (LCHADD) is a rare inborn error of metabolism. It is associated with hypertrophic cardiomyopathy and less frequently with dilated cardiomyopathy. The incidence and pathophysiology of cardiac involvement in LCHADD is poorly understood. This report describes the acute decompensation of a 3-year-old girl who had LCHADD with rapidly developing dilated cardiomyopathy. A review of the literature and possible causes of cardiomyopathy in LCHADD are explored.
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Bertini E, Dionisi-Vici C, Garavaglia B et al (1992) Peripheral sensory-motor polyneuropathy, pigmentary retinopathy, and fatal cardiomyopathy in long-chain 3-hydroxy-acyl-CoA dehydrogenase deficiency. Eur J Pediatr 151:121–126
Bonnet D, Martin D, Pascale De L et al (1999) Arrhythmias and conduction defects as presenting symptoms of fatty acid oxidation disorders in children. Circulation 100:2248–2253
Colonna P, Iliceto S (2000) Myocardial infarction and left ventricular remodeling: results of the CEDIM trial. Carnitine Ecocardiografia Digitalizzata Infarto Miocardico. Am Heart J 139:S124–S130
Corr PB, Yamada KA (1995) Selected metabolic alterations in the ischemic heart and their contributions to arrhythmogenesis. Herz 20:156–168
den Boer ME, Wanders RJ, Morris AA et al (2002) Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency: clinical presentation and follow-up of 50 patients. Pediatrics 109:99–104
Gillingham MB, Connor WE, Matern D et al (2003) Optimal dietary therapy of long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency. Mol Genet Metab 79:114–123
Glasgow AM, Engel AG, Bier DM et al (1983) Hypoglycemia, hepatic dysfunction, muscle weakness, cardiomyopathy, free carnitine deficiency, and long-chain acylcarnitine excess responsive to medium chain triglyceride diet. Pediatr Res 17:319–326
Hagenfeldt L, von Dobeln U, Holme E et al (1990) 3-Hydroxydicarboxylic aciduria–a fatty acid oxidation defect with severe prognosis. J Pediatr 116:387–392
Helton E, Darragh R, Francis P et al (2000) Metabolic aspects of myocardial disease and a role for L-carnitine in the treatment of childhood cardiomyopathy. Pediatrics 105:1260–1270
Jackson S, Bartlett K, Land J et al (1991) Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency. Pediatr Res 29:406–411
Martins E, Costa A, Silva E et al (1996) Lethal dilated cardiomyopathy due to long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency. J Inherit Metab Dis 19:373–374
Olpin SE, Clark S, Andresen BS et al (2005) Biochemical, clinical, and molecular findings in LCHAD and general mitochondrial trifunctional protein deficiency. J Inherit Metab Dis 28:533–544
Pons R, Roig M, Riudor E et al (1996) The clinical spectrum of long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency. Pediatr Neurol 14:236–243
Primassin S, Ter Veld F, Mayatepek E, Spiekerkoetter U (2008) Carnitine supplementation induces acylcarnitine production in tissues of very long-chain acyl-CoA dehydrogenase-deficient mice, without replenishing low free carnitine. Pediatr Res 63:632–637
Rocchiccioli F, Wanders RJ, Aubourg P et al (1990) Deficiency of long-chain 3-hydroxyacyl-CoA dehydrogenase: a cause of lethal myopathy and cardiomyopathy in early childhood. Pediatr Res 28:657–662
Roe C, Ding J (2001) Chapter 101 mitochondrial fatty acid oxidation disorders. In: Scriver C, Beaudet A, Sly W et al (eds) The Metabolic and Molecular Bases of Inherited Diseases (MMBID). McGraw Hill, New York, pp 2297–2326
Roe CR, Roe DS, Wallace M, Garritson B (2007) Choice of oils for essential fat supplements can enhance production of abnormal metabolites in fat oxidation disorders. Mol Genet Metab 92:346–350
Saudubray JM, Martin D, de Lonlay P et al (1999) Recognition and management of fatty acid oxidation defects: a series of 107 patients. J Inherit Metab Dis 22:488–502
Spiekerkoetter U, Sun B, Khuchua Z et al (2003) Molecular and phenotypic heterogeneity in mitochondrial trifunctional protein deficiency due to beta-subunit mutations. Hum Mutat 21:598–607
Tyni T, Palotie A, Viinikka L et al (1997) Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency with the G1528C mutation: clinical presentation of thirteen patients. J Pediatr 130:67–76
Wanders RJ, Ijlst L, Duran M et al (1991) Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency: different clinical expression in three unrelated patients. J Inherit Metab Dis 14:325–328
Winter SC (2003) Treatment of carnitine deficiency. J Inherit Metab Dis 26:171–180
Winter SC, Buist NR (2000) Cardiomyopathy in childhood, mitochondrial dysfunction, and the role of L-carnitine. Am Heart J 139:S63–S69
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Dyke, P.C., Konczal, L., Bartholomew, D. et al. Acute Dilated Cardiomyopathy in a Patient with Deficiency of Long-Chain 3-Hydroxyacyl-CoA Dehydrogenase. Pediatr Cardiol 30, 523–526 (2009). https://doi.org/10.1007/s00246-008-9351-8
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DOI: https://doi.org/10.1007/s00246-008-9351-8