Very long-chain acyl-coenzyme A dehydrogenase deficiency
Other namesVLCADD
Very long-chain acyl-coenzyme: A dehydrogenase deficiency has an autosomal recessive pattern of inheritance.

Very long-chain acyl-coenzyme A dehydrogenase deficiency is a fatty-acid metabolism disorder which prevents the body from converting certain fats to energy, particularly during periods without food.[1][2][3]

Those affected by this disorder have inadequate levels of an enzyme that breaks down a group of fats called very long-chain fatty acids.[citation needed][4]


Signs and symptoms can include:[5]


Mutations in the ACADVL gene lead to inadequate levels of an enzyme called very long-chain acyl-coenzyme A (CoA) dehydrogenase. Without this enzyme, very long-chain fatty acids from food and fats stored in the body cannot be degraded and processed. As a result, these fatty acids are not converted into energy, which can lead to characteristic signs and symptoms of this disorder, such as lethargy and hypoglycemia. Levels of very long-chain fatty acids or partially degraded fatty acids may build up in tissues and can damage the heart, liver, and muscles, causing more serious complications.


Typically, initial signs and symptoms of this disorder occur during infancy and include low blood sugar (hypoglycemia), lack of energy (lethargy), and muscle weakness. There is also a high risk of complications such as liver abnormalities and life-threatening heart problems. Symptoms that begin later in childhood, adolescence, or adulthood tend to be milder and usually do not involve heart problems. Episodes of very long-chain acyl-coenzyme A dehydrogenase deficiency can be triggered by periods of fasting, illness, and exercise.

It is common for babies and children with the early and childhood types of VLCADD to have episodes of illness called metabolic crises. Some of the first symptoms of a metabolic crisis are: extreme sleepiness, behavior changes, irritable mood, poor appetite. Some of these other symptoms of VLCADD in infants may also follow: fever, nausea, diarrhea, vomiting, hypoglycemia.


If a metabolic crisis is not treated, a child with VLCADD can develop: breathing problems, seizures, coma, sometimes leading to death.


  1. ^ Leslie, Nancy D.; Valencia, C. Alexander; Strauss, Arnold W.; Connor, Jessica A.; Zhang, Kejian (1993-01-01). "Very Long-Chain Acyl-Coenzyme a Dehydrogenase Deficiency". In Pagon, Roberta A.; Adam, Margaret P.; Ardinger, Holly H.; Wallace, Stephanie E.; Amemiya, Anne; Bean, Lora JH; Bird, Thomas D.; Ledbetter, Nikki; Mefford, Heather C. (eds.). GeneReviews(®). Seattle (WA): University of Washington, Seattle. PMID 20301763.update 2014
  2. ^ Reference, Genetics Home. "VLCAD deficiency". Genetics Home Reference. Retrieved 2017-02-27.
  3. ^ "VLCAD deficiency | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". Retrieved 2018-04-17.
  4. ^ Reference, Genetics Home. "VLCAD deficiency". Genetics Home Reference. Retrieved 2018-04-17.
  5. ^ "Very Long Chain Acyl CoA Dehydrogenase Deficiency (LCAD)".

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