The syndrome of systemic carnitine deficiency: Clinical, morphologic, biochemical, and pathophysiologic features

George Karpati, Stirling Carpenter, Andrew G. Engel, Gordon Watters, Jeffrey Allen, Stanley Rothman, Gerald Klassen, Orval A. Mamer

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Abstract

An 11-year-old boy had had recurrent episodes of hepatic and cerebral dysfunction and underdeveloped musculature. Overt weakness developed at age 10. Lipid excess, especially in type I fibers, was found in muscle. Hypertrophied smooth endoplasmic reticulum and excessive microbodies were present in liver. Marked carnitine deficiency was shown in skeletal muscle, plasma, and liver. Ketogenesis was impaired on a high fat diet, but omega oxidation of fatty acids was enhanced. There was excessive glucose uptake and essentially no oxidation of labeled long-chain fatty acids by perfused forearm muscles in vivo. Oral replacement therapy restored plasma carnitine levels to normal, but not liver or muscle carnitine levels, and was accompanied by clinical improvement.

Original languageEnglish (US)
Pages (from-to)16-24
Number of pages9
JournalNeurology
Volume25
Issue number1
StatePublished - Jan 1975

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ASJC Scopus subject areas

  • Clinical Neurology

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Karpati, G., Carpenter, S., Engel, A. G., Watters, G., Allen, J., Rothman, S., Klassen, G., & Mamer, O. A. (1975). The syndrome of systemic carnitine deficiency: Clinical, morphologic, biochemical, and pathophysiologic features. Neurology, 25(1), 16-24.