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43: Inborn Errors of Metabolism
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Published:May 2023
Sridaran Narayanan, MD, FAAP, Tamanna Roshan Lal, MB ChB, FAAP, FACMG, "Inborn Errors of Metabolism", Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics, American Academy of Pediatrics Section on Hospital Medicine, Jeffrey C. Gershel, MD, FAAP, Daniel A. Rauch, MD, FAAP, SFHM
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Inborn errors of metabolism (IEMs) encompass deficiencies of enzymes or cofactors that normally aid in the breakdown of carbohydrates, proteins, fats, and other molecules. These defects can cause a buildup of potentially toxic metabolites and a defect in energy production, most commonly leading to hypoglycemia, hyperammonemia, and/or anion gap metabolic acidosis. State newborn screening programs aid in the early diagnosis and treatment of many, but not all, of these illnesses. A patient with an IEM is at highest risk for morbidity or mortality when caloric intake (especially glucose) is poor or when there is an intercurrent illness. They are then...