Carnitine Deficiency with Hyperbilirubinemia, Generalized Skeletal Muscle Weakness and Reactive Hypoglycemia in a Patient on Long‐term Total Parenteral Nutrition: Treatment with Intravenous L‐Carnitine

Abstract

Low levels of plasma carnitine and reduced urinary carnitine excretion with persistently elevated plasma bilirubin levels, reactive hypoglycemia and generalized skeletal muscle weakness are described in a patient requiring long-term total parenteral nutrition (TPN). Intravenous administration of L-carnitine at 400 mg/day for 7 days and subsequently a maintenance dose of 60 mg/day corrected the plasma carnitine deficiency and reactive hypoglycemia and was associated with a return to normal plasma bilirubin levels and a restoration of skeletal muscle strength.