Okanari, K., Takahashi, M., Maeda, T., Sato, K., Suenobu, S., and Izumi, T.
A 1-year and 11-month-old female infant with bilateral lesions of the thalamus, basal ganglia, cerebellar and brainstem disease died from heart failure 9 days after being administered a measles vaccination. She had a high fever, hypocarnitinemic and non-ketotic hypoglycemia, serum levels of total carnitine 7.4μmol/L, free carnitine 5.6μmoI/L, acylcarnitine 1.8μmol/L and glucose 13mg/dL. Due to feeding difficulty, the patient, however, had been administered parenteral elementary nutrition through a feeding tube since early infancy. The commercially available parenteral nutrition solutions do not contain carnitine. A secondary carnitine deficiency followed by non-ketotic hypoglycemia-related heart failure may readily develop even in a patient without valproic acid, during high fever. [ABSTRACT FROM AUTHOR]