title: Ethylmalonic adipic aciduria--a treatable hepatomuscular disorder in two adult brothers.
abstract: An adult male presented at 28 years of age with muscle weakness and liver dysfunction. His brother had died suddenly 2 years earlier after presenting with Reye's syndrome. Urine organic acid analysis and muscle and cultured fibroblast fatty acid oxidation studies confirmed a diagnosis of ethylmalonic/adipic aciduria-an inherited defect of fatty acid oxidation. The patient responded favourably to treatment with a low fat/high carbohydrate diet supplemented with riboflavin. This case highlights the importance of considering inborn errors of metabolism, in particular fatty acid oxidation defects, in adults with liver disease, muscle disease or Reye's syndrome.
authors.affiliation: Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: E
authors.initials: E
authors.lastname: Elias
authors.forename: R G
authors.initials: RG
authors.lastname: Gray
authors.forename: K
authors.initials: K
authors.lastname: Poulton
authors.forename: A
authors.initials: A
authors.lastname: Green
mesh_terms: D000272:Adipates / Q000652:urine*; D000328:Adult; D006801:Humans; D008052:Lipid Metabolism, Inborn Errors / Q000150:complications*; D008107:Liver Diseases / Q000209:etiology* / Q000628:therapy; D008297:Male; D008314:Malonates / Q000652:urine*; D009135:Muscular Diseases / Q000209:etiology* / Q000628:therapy; D012202:Reye Syndrome / Q000209:etiology
chemical_list: D000272:Adipates; D008314:Malonates; C038080:ethylmalonic acid; C029900:adipic acid