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. 2013 Dec 4;8:188. doi: 10.1186/1750-1172-8-188

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Copyright © 2013 Ferdinandusse et al.; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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HIBCH deficiency leads to accumulation of hydroxy-C4-carnitine. (a) Valine degradation pathway. 3-Hydroxy-isobutyrylCoA hydrolase (HIBCH) catalyses the fifth step of valine catabolism. HIBCH deficiency leads to accumulation of 3-hydroxy-isobutyryl carnitine, which is detected as hydroxy-C4-carnitine by tandem mass spectrometry. (b) Plasma acylcarnitine analysis by tandem mass spectrometry. Left panel: normal acylcarnitine profile; Right panel: acylcarnitine profile from Patient 2 with accumulating hydroxy-C4-carnitine indicated by arrow.