An acquired carnitine deficiency should be considered if certain risk factors are considered.
Carnitine is beta-hydroxy-gamma-N-trimethylamino-butyrate (alternatively 3-hydroxy-4-trimethylamino-butyric acid).
Risk factors for an acquired carnitine deficiency:
(1) severe long-standing malnutrition (decreased absorption)
(2) pure Vegan diet (decreased intake associated with low plant content of carnitine)
(3) hepatic cirrhosis (decreased synthesis)
(4) renal failure (decreased synthesis)
(5) chronic hemodialysis (increased loss)
(6) diabetes mellitus
(7) chronic heart failure
(8) Alzheimer's disease
(9) renal Fanconi syndrome
(10) sepsis (catabolism and increased fatty acid oxidation)
(11) multi-organ failure (catabolism increased fatty acid oxidation)
(12) massive trauma (catabolism increased fatty acid oxidation)
(13) prolonged fasting (catabolism increased fatty acid oxidation)
(14) therapy with a drug associated with carnitine deficiency (see previous section)
(15) premature infant (impaired synthesis and increased demands)
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