J Korean Pediatr Soc.
2000 Jun;43(6):828-831.
Isovaleric Acidemia in Siblings Diagnosed by Organic Acid Analysis
Abstract
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Isovaleric acidemia is an inborn error in metabolism due to a defect in isovaleryl-CoA
dehydrogenase. Accumulation of serum isovaleric acid causes poor feeding, vomiting, lethargy,
hypothermia, convulsion, mental retardation, etc. It is inherited as an autosomal recessive
trait. Since the first reports of isovaleric acidemia by Tanaka et al in 1966, more than 60
cases have been reported. There are two clinically different presentations of isovaleric
acidemia, with about half the patients presenting with an acute severe neonatal form and
about half with a chronic intermittent forrn. The difference in clinical presentation may
not be a consequence of differing severities of the causative mutation, but a result of
the timing of application of catabolic stress or the ability to form isovalerylglycine. We
described here clinical and organic acid analytical findings of brothers with chronic
intermittent form of isovaleric acidemia. (J Korean Pediatr Soc 2000;43:828-831)