46 Isobutyryl-coa dehydrogenase deficiency (ibd deficiency) is an inborn error of valine (an amino acid) metabolism. the symptoms, which may not develop until later in infancy or childhood, can include failure to thrive, dilated cardiomyopathy, seizures, and anemia. ibd deficiency is caused by mutations in the acad8 gene. it is inherited in an autosomal recessive manner. treatment may include the use of l-carnitine (a safe and natural substance that helps the body's cells make energy), frequent meals, and a low-valine diet

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