Fatal systemic carnitine deficiency with lipid storage in skeletal muscle, heart, liver and kidney

G. Boudin, J. Mikol, A. Guillard, Andrew G Engel

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Abstract

A fatal case of systemic carnitine deficiency is reported. The patient suffered from slowly progressive muscle weakness since early childhood. After the age of 17 years her weakness progressed more rapidly until her death at the age of 20. A pregnancy during the last year of the patient's life was followed by rapid deterioration in her condition. An episode of renal insufficiency occurred at the age of 17 years and hepatomegaly, increased BSP dye retention and intermittent ketoacidosis were present during the last month of her life. Biopsy and autopsy specimens of muscle showed a lipid storage myopathy. Type 1 fibers were selectively severely affected, and many Type 1 fibers were atrophic. Abundant large mitochondria, some also containing abnormal inclusions, were also present in the muscle fibers. At autopsy there was marked accumulation of sudanophilic lipid deposits in all hepatocytes, in the renal tubular epithelial cells, and a patchy increase of lipid material was found in the myocardial fibers. There was marked carnitine deficiency in the patient's liver as well as muscle, while the carnitine palmityltransferase activities in these tissues were abnormally high. The basic metabolic abnormality is assumed to be a defect in carnitine biosynthesis.

Original languageEnglish (US)
Pages (from-to)313-325
Number of pages13
JournalJournal of the Neurological Sciences
Volume30
Issue number2-3
DOIs
StatePublished - 1976

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Carnitine
Skeletal Muscle
Kidney
Lipids
Muscles
Autopsy
Liver
Ketosis
Hepatomegaly
Muscle Weakness
Renal Insufficiency
Hepatocytes
Mitochondria
Coloring Agents
Epithelial Cells
Biopsy
Pregnancy
Systemic carnitine deficiency

ASJC Scopus subject areas

  • Aging
  • Clinical Neurology
  • Surgery
  • Neuroscience(all)
  • Developmental Neuroscience
  • Neurology

Cite this

Fatal systemic carnitine deficiency with lipid storage in skeletal muscle, heart, liver and kidney. / Boudin, G.; Mikol, J.; Guillard, A.; Engel, Andrew G.

In: Journal of the Neurological Sciences, Vol. 30, No. 2-3, 1976, p. 313-325.

Research output: Contribution to journalArticle

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AB - A fatal case of systemic carnitine deficiency is reported. The patient suffered from slowly progressive muscle weakness since early childhood. After the age of 17 years her weakness progressed more rapidly until her death at the age of 20. A pregnancy during the last year of the patient's life was followed by rapid deterioration in her condition. An episode of renal insufficiency occurred at the age of 17 years and hepatomegaly, increased BSP dye retention and intermittent ketoacidosis were present during the last month of her life. Biopsy and autopsy specimens of muscle showed a lipid storage myopathy. Type 1 fibers were selectively severely affected, and many Type 1 fibers were atrophic. Abundant large mitochondria, some also containing abnormal inclusions, were also present in the muscle fibers. At autopsy there was marked accumulation of sudanophilic lipid deposits in all hepatocytes, in the renal tubular epithelial cells, and a patchy increase of lipid material was found in the myocardial fibers. There was marked carnitine deficiency in the patient's liver as well as muscle, while the carnitine palmityltransferase activities in these tissues were abnormally high. The basic metabolic abnormality is assumed to be a defect in carnitine biosynthesis.

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