“…[5] and thus decrease the β-oxidation of fatty acids in both mitochondria and peroxisomes. The MLYCD gene has a tissue-specific expression pattern [6,7] with the highest message levels in the heart muscle, then the skeletal muscle, followed by the brain, small intestine, liver, kidney and pancreas. The characteristic phenotype is variable, but may include developmental delays in early childhood, seizures, hypotonia, diarrhea, vomiting, metabolic acidosis, hypoglycemia, ketosis, abnormal urinary compounds, lactic acidemia, and hypertrophic cardiomyopathy [8].…”