Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency
Synonyms	LCHAD deficiency
Pronounce
Specialty	Medical genetics
Symptoms	Hypoglycemia, cardiomyopathy, muscle weakness, liver dysfunction
Complications	N/A
Onset	Infancy
Duration	Lifelong
Types	N/A
Causes	Mutations in the HADHA gene
Risks
Diagnosis	Genetic testing, newborn screening
Differential diagnosis	Medium-chain acyl-CoA dehydrogenase deficiency, trifunctional protein deficiency
Prevention
Treatment	Dietary management, medium-chain triglycerides
Medication
Prognosis	Variable, can be life-threatening if untreated
Frequency	Rare
Deaths

Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency

Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency (LCHAD deficiency) is a rare genetic disorder that affects the breakdown of certain fats in the body. It is classified as a fatty acid oxidation disorder (FAOD) and is caused by mutations in the HADHA gene, which provides instructions for making an enzyme called long-chain 3-hydroxyacyl-coenzyme A dehydrogenase.

Symptoms

Individuals with LCHAD deficiency may experience a range of symptoms, which can vary in severity. Common symptoms include:

• Muscle weakness
• Low blood sugar
• Enlarged liver
• Heart problems
• Vision problems
• Developmental delays
• Neurological abnormalities

Diagnosis

Diagnosing LCHAD deficiency involves a combination of clinical evaluation, biochemical testing, and genetic testing. Blood tests can reveal elevated levels of certain fatty acids and organic acids, which can help in the diagnosis. Genetic testing can confirm the presence of mutations in the HADHA gene.

Treatment

There is currently no cure for LCHAD deficiency, but treatment focuses on managing symptoms and preventing complications. This may involve:

• Dietary modifications: Individuals with LCHAD deficiency may need to follow a special diet that is low in long-chain fatty acids and high in carbohydrates. This can help prevent the buildup of toxic byproducts and provide alternative energy sources for the body.
• Supplementation: Some individuals may require specific supplements, such as carnitine or medium-chain triglycerides, to support their metabolism and overall health.
• Monitoring and support: Regular monitoring of blood markers and close medical supervision are essential to manage the condition effectively. Supportive therapies, such as physical therapy and occupational therapy, may also be beneficial.

Prognosis

The prognosis for individuals with LCHAD deficiency can vary depending on the severity of the condition and the age of onset. Early diagnosis and appropriate management can significantly improve outcomes. However, some individuals may experience long-term complications, such as heart problems or neurological impairments.

Research

Ongoing research is focused on understanding the underlying mechanisms of LCHAD deficiency and developing new treatment strategies. This includes investigating potential gene therapies, enzyme replacement therapies, and targeted drug interventions.

See also

• Fatty acid oxidation disorders
• Inborn errors of metabolism
• Genetic disorders