Fatty Acid Oxidation Disorders |
| Disease Name | Very long-chain acyl-CoA dehydrogenase deficiency |
| Alternate name(s) | N/A |
| Acronym | VLCADD |
| Disease Classification | Fatty Acid Oxidation Disorder |
| Variants | Yes |
| Variant name | With and without cardiomyopathy |
| Symptom onset | Primarily neonatal but some variability. |
| Symptoms | Hypoketotic hypoglycemia, hepatomegaly, myopathy, |
| Natural history without treatment | Sudden infant death due to cardiac abnormalities is common. |
| Natural history with treatment | Diagnosis and treatment seem to decrease risk for sudden death. |
| Treatment | Avoidance of fasting, high carbohydrate, low-fat diet supplemented with MCT oil, IV glucose during illness, cornstarch supplementation, avoidance of long chain fatty acids, possible carnitine supplementation. |
| Other | May have history of a sibling dying of SIDS. |
| Physical phenotype | No particular dysmorphisms. Cardiomyopathy in infants. |
| Inheritance | Autosomal recessive |
| General population incidence | Rare – exact incidence not known |
| Ethnic differences | None reported |
| Population | N/A |
| Ethnic incidence | N/A |
| Enzyme location | Mitochondrial matrix, heart, liver |
| Enzyme Function | Long chain fatty acid beta-oxidation |
| Missing Enzyme | Very long-chain acyl-CoA dehydrogenase |
| Metabolite changes | IDicarboxylic aciduria, decreased urinary carnitine at times of illness, plasma free carnitine - normal to low, increased plasma long-chain acylcarnitines mildly increased ammonia, lactate and creatine kinase. |
| Gene | ACADVL |
| Gene location | 17p11.2-p11.1 |
| DNA testing available | Available on a research basis |
| DNA testing detail | No common mutations have been found. If a mutation in a proband is detected, DNA carrier screening is possible. |
| Prenatal testing | Enzyme and protein analysis. If a mutation in a proband is detected, DNA prenatal diagnosis via CVS or amniocytes is possible. |
| MS/MS Profile | Elevated C16:1, C14:2, C14:1, C18:1 |
| OMIM Link | http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=201475 |
| Genetests Link | www.genetests.org |
| Support Group | FOD Family Support Group Save Babies through Screening Foundation |