Risk factors for carnitine deficiency in an infant:
(1) premature infant with an inadequate ability to synthesize carnitine
(2) increased demands if admitted to the intensive care unit or septic
(3) increased demands due to organic aciduria or other inherited metabolic disorder
(4) breast feeding by a mother with decreased body stores of carnitine
(5) nutritional support without carnitine supplementation
(6) hemodialysis
Manifestations:
(1) hypoketotic hypoglycemia with or without encephalopathy
(2) unexplained heart failure
(3) unexplained hepatomegaly and hepatic dysfunction, including hepatic failure resembling Reye's syndrome
(4) hyperammonemia
The presence of one or more manifestations without any risk factors may indicate the presence of a primary disorder of carnitine metabolism.
