Relative carnitine deficiency is important in the pathophysiology of several disorders, including Reye’s syndrome and organic acidemias. In acute clinical crises, carnitine serves as a “buffer,” trapping toxic acyl compounds. Mitochondrial failure develops in carnitine deficiency when there is insufficient tissue carnitine available to buffer toxic acyl-CoA metabolites. Toxic levels of acyl-Co A impair the citrate cycle, gluconeogenesis, the urea cycle, and fatty-acid oxidation. Carnitine replacement therapy is safe and induces excretion of toxic acyl groups in the urine.
ASJC Scopus subject areas
- Clinical Neurology