A Rare Case Report of Hypoketotic Hypoglycemia Induced Seizures Due to Secondary Carnitine Deficiency In a 44-year-old Female

Authors

Ayrton Bangolo, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.0Follow
Nicole Tesoro, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Sonia Onyeka, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Mary Bangura, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Rekha Shrestha, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA
Vignesh K. Nagesh, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Roua Alrestom, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Joshua Rathod, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Eugenio L. Gomez, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Youssef Laabidi, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Imane Laabidi, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA
Conrad Erikson, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Aayat Sheikh, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA
Sharon Maria, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA
Mansi Naria, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA
Erwin J. Tabucanon, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA
Juilee V. Dongre, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Auda Auda, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Mohammed Jurri, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Reshma Radhakrishnan, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA.
Hisham Alrefai, Department of Endocrinology, Endocrines Associates, Louisville, KY, USA
Simcha Weissman, Department of Medicine. Palisades Medical Center, North Bergen, NJ, USA

Abstract

Carnitine deficiency is a rare metabolic condition that can result in fasting hypoglycemia. Carnitine deficiency could be primary or secondary to other conditions. Among secondary causes, antiepileptics such as valproic acid have been incriminated. Valproic acid is known to deplete carnitine stores and inhibit the process of β-oxidation. Herein we report the case of a 44-year-old female with epilepsy that presented with breakthrough seizures associated with hypoglycemia despite being on appropriate antiepileptic therapy. The patient was later found to have carnitine deficiency. Discontinuation of valproic acid and supplementation with L-carnitine resolved the patient’s hypoglycemia and breakthrough seizures. With this case report, we hope to encourage clinicians to include carnitine deficiency in the differential diagnosis of unexplained hypoglycemia.

Recommended Citation

Bangolo, Ayrton; Tesoro, Nicole; Onyeka, Sonia; Bangura, Mary; Shrestha, Rekha; Nagesh, Vignesh K.; Alrestom, Roua; Rathod, Joshua; Gomez, Eugenio L.; Laabidi, Youssef; Laabidi, Imane; Erikson, Conrad; Sheikh, Aayat; Maria, Sharon; Naria, Mansi; Tabucanon, Erwin J.; Dongre, Juilee V.; Auda, Auda; Jurri, Mohammed; Radhakrishnan, Reshma; Alrefai, Hisham; and Weissman, Simcha (2024) "A Rare Case Report of Hypoketotic Hypoglycemia Induced Seizures Due to Secondary Carnitine Deficiency In a 44-year-old Female," Journal of Community Hospital Internal Medicine Perspectives: Vol. 14: Iss. 3, Article 13.
DOI: 10.55729/2000-9666.1279
Available at: https://scholarlycommons.gbmc.org/jchimp/vol14/iss3/13