Glutaric aciduria type 2 (GA-II)

Alternative name Multiple acyl-CoA dehydrogenase deficiency (MADD)
About the condition GA-II is predominantly a fatty acid oxidation disorder. It is a hereditary disease that is caused by a missing enzyme complex needed to convert fat and some amino acids into energy.
Inheritance Autosomal recessive
Year screening started in WA 2005
Incidence in Australia Currently unknown
Enzyme defect Deficiency of electron transfer flavoprotein (ETF) or electron transfer flavoprotein dehydrogenase (ETF-DH).
Symptoms if untreated
  • Hypoglycaemia
  • Hyperammonaemia
  • Cardiomyopathy
  • Polycystic kidneys
  • Hepatomegaly
  • ‘Sweaty feet’ odour
  • Coma and death possible
Metabolites on bloodspot screening Multiple increased acylcarnitines (C4, C5, C5DC, C6, C8, C0, C12, C14, C14:1, C16, C18, and C18:1).
Diagnostic tests
  • Plasma acylcarnitine profile
  • Urine organic acids
  • Plasma amino acids
  • ETF and ETFDH gene analysis
Treatment
  • Regulation of dietary fat intake
  • Carnitine supplementation
  • Riboflavin supplementation
  • Avoidance of fasting
  • Intervention if hypoglycaemia and/or acidosis
Screening issues Later-onset and milder variants occur.