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George P. Giacoia, MD; Gerald T. Berry, MD

Am J Dis Child. 1993;147(9):954-956.

Abstract
• We describe a patient with maple syrup urine disease in whom an acrodermatitis enteropathica–like syndrome developed while he was receiving a branched-chain amino acid–free formula. latrogenically induced isoleucine deficiency developed and resulted in a decreased protein accretion and persistent increase in the plasma concentrations of leucine. A rapid clinical response to isoleucine supplementation was noted. This observation underscores the risks of using amino acid–free formulas without adequate supplementation of deficient amino acids.

(AJDC. 1993;147:954-956)

Author Affiliations
From the Division of Neonatology, Department of Pediatrics, University of Oklahoma College of Medicine, Tulsa (Dr Giacoia), and the Division of Biochemical Development and Molecular Diseases, Department of Pediatrics, University of Pennsylvania School of Medicine, the Children's Hospital of Philadelphia (Dr Berry).

Footnotes
Accepted for publication February 25, 1993.

Reprint requests to Department of Pediatrics, The University of Oklahoma College of Medicine, 6161 S Yale, Tulsa, OK 74136 (Dr Giacoia).

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