CUD
MCID: SYS002
MIFTS: 60

Systemic Primary Carnitine Deficiency Disease (CUD) malady

Genetic diseases, Rare diseases, Neuronal diseases, Nephrological diseases categories

Summaries for Systemic Primary Carnitine Deficiency Disease

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9Disease Ontology, 22Genetics Home Reference, 44NIH Rare Diseases, 48OMIM, 20GeneReviews, 34MalaCards
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NIH Rare Diseases:44 Primary carnitine deficiency is a genetic condition that prevents the body from using certain fats for energy, particularly during periods without food (fasting). the nature and severity of signs and symptoms may vary, but they most often appear during infancy or early childhood and can include severe brain dysfunction (encephalopathy), cardiomyopathy, confusion, vomiting, muscle weakness, and hypoglycemia. some individuals may only have fatigability in adulthood, or no symptoms at all. this condition is caused by mutations in the slc22a5 gene and is inherited in an autosomal recessive manner. treatment and prevention of symptoms typically includes oral l-carnitine supplementation. last updated: 7/9/2012

MalaCards: Systemic Primary Carnitine Deficiency Disease, also known as systemic primary carnitine deficiency, is related to primary ciliary dyskinesia and tardbp-related amyotrophic lateral sclerosis. An important gene associated with Systemic Primary Carnitine Deficiency Disease is SLC22A5 (solute carrier family 22 (organic cation/carnitine transporter), member 5), and among its related pathways are triacylglycerol biosynthesis and PPAR signaling pathway. The compounds riboflavin and triacylglycerol have been mentioned in the context of this disorder. Affiliated tissues include brain, heart and skeletal muscle, and related mouse phenotypes are muscle and liver/biliary system.

Disease Ontology:9 An amino acid metabolic disorder that involves defective proteins called carnitine transporters, which bring carnitine into cells and prevent its escape from the body preventing the body cannot utilize fats for energy.

Genetics Home Reference:22 Primary carnitine deficiency is a condition that prevents the body from using certain fats for energy, particularly during periods without food (fasting). Carnitine, a natural substance acquired mostly through the diet, is used by cells to process fats and produce energy.

Description from OMIM:48 212140

GeneReviews summary for cdsp

Aliases & Classifications for Systemic Primary Carnitine Deficiency Disease

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9Disease Ontology, 10diseasecard, 20GeneReviews, 44NIH Rare Diseases, 21GeneTests, 23GTR, 22Genetics Home Reference, 48OMIM, 11DISEASES, 46Novoseek, 50Orphanet, 63UMLS, 36MeSH, 28ICD9CM, 59SNOMED-CT, 27ICD10 via Orphanet
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Classifications:



Characteristics (Orphanet epidemiological data):

50
systemic primary carnitine deficiency:
Inheritance: Autosomal recessive; Prevalence: 1-9/100000; Age of onset: Neonatal/infancy; Age of death: Normal


Aliases & Descriptions:

systemic primary carnitine deficiency disease 9 11
systemic primary carnitine deficiency 20 44 21 50
renal carnitine transport defect 9 23 22 63
carnitine uptake deficiency 44 22 50 63
carnitine uptake defect 9 20 44 22
carnitine transporter deficiency 9 44 22
primary carnitine deficiency 9 44 22
cud 20 22 50
deficiency of plasma-membrane carnitine transporter 9 50
carnitine deficiency, systemic primary 10 48
carnitine deficiency, systemic, due to defect in renal reabsorption of carnitine 44
carnitine plasma-membrane transporter deficiency 44
primary systemic carnitine deficiency 50
systemic carnitine deficiency 22
carnitine deficiency, primary 46
carnitine transporter defect 50
cdsp 20
pcd 50


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Disease Ontology9 DOID:14365
MeSH36 C536778
ICD9CM28 277.81
SNOMED-CT59 21764004
OMIM48 212140
ICD10 via Orphanet27 E71.3

Related Diseases for Systemic Primary Carnitine Deficiency Disease

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18GeneCards, 19GeneDecks
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Diseases related to Systemic Primary Carnitine Deficiency Disease via text searches within MalaCards or GeneCards/GeneDecks gene sharing:

(show all 40)
idRelated DiseaseScoreTop Affiliating Genes
1primary ciliary dyskinesia10.5
2tardbp-related amyotrophic lateral sclerosis10.3
3reye syndrome10.3
4paraneoplastic cerebellar degeneration10.2
5citrin deficiency10.2
6holocarboxylase synthetase deficiency10.2
7glycogen storage disease10.2
8neuropathy10.2
9peripheral neuropathy10.2
10retinitis10.1
11endocardial fibroelastosis10.1
12dilated cardiomyopathy10.1
13long qt syndrome10.1
14visceral steatosis10.1
15lipid storage disease10.1
16pericardial effusion10.1
17glutaric acidemia iic10.1ETFDH
18carnitine palmitoyltransferase ii deficiency10.1CPT2
19medium-chain acyl-coenzyme a dehydrogenase deficiency10.0ACADS, ACADVL
20brain disease10.0ACADS, CPT2
21myoglobinuria recurrent10.0CPT2, ACADVL
22sudden infant death syndrome10.0ACADVL, ACADS, SLC22A5
23bronchiectasis10.0
24microcephaly10.0
25retinitis pigmentosa10.0
26protein c deficiency10.0
27cerebellar ataxia10.0
28wilms tumor10.0
29cerebellar degeneration10.0
30kartagener syndrome10.0
31ataxia10.0
32ciliary dyskinesia, primary, 1910.0
33fatty liver disease10.0SCD, ACADVL, CPT2
34noonan syndrome9.9CPT2, SLC22A5, ACADVL
35hypoglycemia9.9ETFDH, ACADS, CPT2, ACADVL
36myopathy9.9CPT2, ETFDH, ACADS, ACADVL
37insulin resistance9.9PNPLA2, SCD, CPT2
38neutral lipid storage disease9.9SLC22A5, ETFB, ETFDH, PNPLA2, ABHD5
39obesity9.9SCD, PNPLA2, CPT2
40metabolic syndrome x9.8PNPLA2, ACADVL, ACADS, ETFDH, SCD, CPT2

Graphical network of the top 20 diseases related to Systemic Primary Carnitine Deficiency Disease:



Diseases related to systemic primary carnitine deficiency disease

Symptoms for Systemic Primary Carnitine Deficiency Disease

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48OMIM
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Symptoms by clinical synopsis from OMIM:

212140

Clinical features from OMIM:

212140

Drugs & Therapeutics for Systemic Primary Carnitine Deficiency Disease

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6CenterWatch, 43NIH Clinical Center, 7ClinicalTrials, 63UMLS, 42NDF-RT
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Approved drugs:

Search CenterWatch for Systemic Primary Carnitine Deficiency Disease

Drug clinical trials:

Search ClinicalTrials for Systemic Primary Carnitine Deficiency Disease

Search NIH Clinical Center for Systemic Primary Carnitine Deficiency Disease

Search CenterWatch for Systemic Primary Carnitine Deficiency Disease

Genetic Tests for Systemic Primary Carnitine Deficiency Disease

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21GeneTests, 23GTR
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Genetic tests related to Systemic Primary Carnitine Deficiency Disease:

id Genetic test Affiliating Genes
1 Systemic Primary Carnitine Deficiency21 SLC22A5
2 Renal Carnitine Transport Defect23

Anatomical Context for Systemic Primary Carnitine Deficiency Disease

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34MalaCards
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MalaCards organs/tissues related to Systemic Primary Carnitine Deficiency Disease:

34
Brain, Heart, Skeletal muscle, Kidney

Animal Models for Systemic Primary Carnitine Deficiency Disease or affiliated genes

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38MGI
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MGI Mouse Phenotypes related to Systemic Primary Carnitine Deficiency Disease:

38
idDescriptionMGI Source AccessionScoreTop Affiliating Genes
1MP:00053698.5ACADVL, ACADS, PNPLA2, ABHD5
2MP:00053707.9SLC22A5, ACADVL, ACADS, SCD, PNPLA2, ABHD5
3MP:00053767.8ABHD5, PNPLA2, SCD, ACADS, ACADVL, SLC22A5
4MP:00107687.6ABHD5, PNPLA2, SCD, ACADS, ACADVL, SLC22A5

Publications for Systemic Primary Carnitine Deficiency Disease

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Variations for Systemic Primary Carnitine Deficiency Disease

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Sources:
65UniProtKB/Swiss-Prot, 1 National Center for Biotechnology Information (Clinvar), 8dbSNP
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UniProtKB/Swiss-Prot genetic disease variations for Systemic Primary Carnitine Deficiency Disease:

65 (show all 49)
id Symbol AA change Variation ID SNP ID
1SLC22A5p.Arg169GlnVAR_009252
2SLC22A5p.Tyr211CysVAR_009253
3SLC22A5p.Trp283ArgVAR_009254
4SLC22A5p.Val446PheVAR_009255
5SLC22A5p.Glu452LysVAR_009256
6SLC22A5p.Pro478LeuVAR_009257
7SLC22A5p.Phe17LeuVAR_020347
8SLC22A5p.Met179LeuVAR_022564
9SLC22A5p.Trp283CysVAR_022565
10SLC22A5p.Ser467CysVAR_022566rs60376624
11SLC22A5p.Tyr449AspVAR_029315rs11568514
12SLC22A5p.Gly12SerVAR_064109rs139203363
13SLC22A5p.Gly15TrpVAR_064110
14SLC22A5p.Arg19ProVAR_064111
15SLC22A5p.Asn32SerVAR_064112
16SLC22A5p.Pro46SerVAR_064113
17SLC22A5p.Arg83LeuVAR_064116
18SLC22A5p.Asp122TyrVAR_064118
19SLC22A5p.Ala142SerVAR_064120
20SLC22A5p.Arg169TrpVAR_064122
21SLC22A5p.Leu186ProVAR_064124
22SLC22A5p.Ala214ValVAR_064125
23SLC22A5p.Arg227HisVAR_064126rs185551386
24SLC22A5p.Thr232MetVAR_064128rs114269482
25SLC22A5p.Gly234ArgVAR_064129
26SLC22A5p.Gly242ValVAR_064131
27SLC22A5p.Arg257TrpVAR_064132
28SLC22A5p.Thr264ArgVAR_064133
29SLC22A5p.Arg282GlnVAR_064134
30SLC22A5p.Ala301AspVAR_064135
31SLC22A5p.Trp351ArgVAR_064137
32SLC22A5p.Ser355LeuVAR_064138
33SLC22A5p.Ser362LeuVAR_064140
34SLC22A5p.Pro398LeuVAR_064141
35SLC22A5p.Arg399GlnVAR_064142
36SLC22A5p.Arg399TrpVAR_064143
37SLC22A5p.Thr440MetVAR_064144
38SLC22A5p.Ala442IleVAR_064145
39SLC22A5p.Phe443ValVAR_064146
40SLC22A5p.Tyr447CysVAR_064147
41SLC22A5p.Pro455ArgVAR_064148
42SLC22A5p.Thr468ArgVAR_064149
43SLC22A5p.Arg471CysVAR_064150
44SLC22A5p.Arg488CysVAR_064151
45SLC22A5p.Leu507SerVAR_064152
46SLC22A5p.Ser26AsnVAR_066843
47SLC22A5p.Ser280PheVAR_066844
48SLC22A5p.Arg471ProVAR_066845
49SLC22A5p.Arg488HisVAR_066846rs28383481

Clinvar genetic disease variations for Systemic Primary Carnitine Deficiency Disease:

1 (show all 29)
id Gene Name Type Significance SNP ID Assembly Location
1SLC22A5NM_003060.3(SLC22A5): c.51C> G (p.Phe17Leu)single nucleotide variantPathogenicrs11568520GRCh37Chr 5, 131705715: 131705715
2SLC22A5NM_003060.3(SLC22A5): c.248G> T (p.Arg83Leu)single nucleotide variantPathogenicrs72552726GRCh37Chr 5, 131705912: 131705912
3SLC22A5NM_003060.3(SLC22A5): c.424G> T (p.Ala142Ser)single nucleotide variantPathogenicrs151231558GRCh37Chr 5, 131714100: 131714100
4SLC22A5NM_003060.3(SLC22A5): c.695C> T (p.Thr232Met)single nucleotide variantPathogenicrs114269482GRCh37Chr 5, 131721062: 131721062
5SLC22A5NM_003060.3(SLC22A5): c.845G> A (p.Arg282Gln)single nucleotide variantPathogenicrs386134210GRCh37Chr 5, 131722737: 131722737
6SLC22A5NM_003060.3(SLC22A5): c.1193C> T (p.Pro398Leu)single nucleotide variantPathogenicrs144547521GRCh37Chr 5, 131726522: 131726522
7SLC22A5NM_003060.3(SLC22A5): c.1400C> G (p.Ser467Cys)single nucleotide variantPathogenicrs60376624GRCh37Chr 5, 131728257: 131728257
8SLC22A5NM_003060.3(SLC22A5): c.1463G> A (p.Arg488His)single nucleotide variantPathogenicrs28383481GRCh37Chr 5, 131729380: 131729380
9SLC22A5SLC22A5, 113-BP DELdeletionPathogenic
10SLC22A5SLC22A5, 1-BP INS, 226CinsertionPathogenic
11SLC22A5NM_003060.3(SLC22A5): c.396G> A (p.Trp132Ter)single nucleotide variantPathogenicrs72552727GRCh37Chr 5, 131714072: 131714072
12SLC22A5SLC22A5, IVS8AS, G-A, -1single nucleotide variantPathogenic
13SLC22A5SLC22A5, 1394-BP DELdeletionPathogenic
14SLC22A5SLC22A5, 19-BP INS, NT874insertionPathogenic
15SLC22A5SLC22A5, 171-BP DEL, NT875deletionPathogenic
16SLC22A5NM_003060.3(SLC22A5): c.844C> T (p.Arg282Ter)single nucleotide variantPathogenicrs121908886GRCh37Chr 5, 131722736: 131722736
17SLC22A5NM_003060.3(SLC22A5): c.1202dupA (p.Tyr401Terfs)duplicationPathogenicrs121908887GRCh37Chr 5, 131726531: 131726532
18SLC22A5SLC22A5, 1-BP DEL, 1345GdeletionPathogenic
19SLC22A5NM_003060.3(SLC22A5): c.1433C> T (p.Pro478Leu)single nucleotide variantPathogenicrs72552735GRCh37Chr 5, 131728290: 131728290
20SLC22A5NM_003060.3(SLC22A5): c.632A> G (p.Tyr211Cys)single nucleotide variantPathogenicrs121908888GRCh37Chr 5, 131719973: 131719973
21SLC22A5NM_003060.3(SLC22A5): c.506G> A (p.Arg169Gln)single nucleotide variantPathogenicrs121908889GRCh37Chr 5, 131719847: 131719847
22SLC22A5NM_003060.3(SLC22A5): c.505C> T (p.Arg169Trp)single nucleotide variantPathogenicrs121908890GRCh37Chr 5, 131719846: 131719846
23SLC22A5NM_003060.3(SLC22A5): c.1051T> C (p.Trp351Arg)single nucleotide variantPathogenicrs68018207GRCh37Chr 5, 131724712: 131724712
24SLC22A5NM_003060.3(SLC22A5): c.1196G> A (p.Arg399Gln)single nucleotide variantPathogenicrs121908891GRCh37Chr 5, 131726525: 131726525
25SLC22A5NM_003060.3(SLC22A5): c.3G> T (p.Met1Ile)single nucleotide variantPathogenicrs121908892GRCh37Chr 5, 131705667: 131705667
26SLC22A5NM_003060.3(SLC22A5): c.760C> T (p.Arg254Ter)single nucleotide variantPathogenicrs121908893GRCh37Chr 5, 131721127: 131721127
27SLC22A5NM_003060.3(SLC22A5): c.1195C> T (p.Arg399Trp)single nucleotide variantPathogenicrs267607054GRCh37Chr 5, 131726524: 131726524
28SLC22A5NM_003060.3(SLC22A5): c.1324_1325delGCinsAT (p.Ala442Ile)indelPathogenicrs267607053GRCh37Chr 5, 131728181: 131728182
29SLC22A5NM_003060.3(SLC22A5): c.43G> T (p.Gly15Trp)single nucleotide variantPathogenicrs267607052GRCh37Chr 5, 131705707: 131705707

Expression for genes affiliated with Systemic Primary Carnitine Deficiency Disease

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2BioGPS, 16Gene Expression Omnibus DataSets
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Expression patterns in normal tissues for genes affiliated with Systemic Primary Carnitine Deficiency Disease

Search GEO for disease gene expression data for Systemic Primary Carnitine Deficiency Disease.

Pathways for genes affiliated with Systemic Primary Carnitine Deficiency Disease

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Sources:
51PathCards, 39NCBI BioSystems Database, 31KEGG, 56Reactome, 61Thomson Reuters
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Pathways related to Systemic Primary Carnitine Deficiency Disease according to GeneCards/GeneDecks:

idSuper pathways (with members indented)ScoreTop Affiliating Genes
1
Show member pathways
phosphatidylglycerol biosynthesis II (non-plastidic)39
CDP-diacylglycerol biosynthesis I39
Triacylglyceride Synthesis39
9.6PNPLA2, ABHD5
2
Show member pathways
fatty acid beta-oxidation VI (peroxisome)39
9.3CPT2, SCD
3
Show member pathways
8.6CPT2, ACADS, ACADVL
4
Show member pathways
mitochondrial L-carnitine shuttle pathway39
Saturated fatty acid biosynthesis61
8.3SCD, CPT2, ACADS, ACADVL
5
Show member pathways
fatty acid beta-oxidation III (unsaturated, odd number)39
Fatty Acid Beta Oxidation39
8.1ACADVL, ACADS, CPT2, PNPLA2
6
Show member pathways
6.7ABHD5, PNPLA2, CPT2, ETFDH, ETFB, ACADS

Compounds for genes affiliated with Systemic Primary Carnitine Deficiency Disease

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46Novoseek, 25HMDB, 12DrugBank
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Compounds related to Systemic Primary Carnitine Deficiency Disease according to GeneCards/GeneDecks:

(show top 50)    (show all 167)
idCompoundScoreTop Affiliating Genes
1riboflavin46 25 1211.7ETFDH, ACADS
2triacylglycerol469.7SCD, PNPLA2, ABHD5
3L-Carnitine25 1210.5SLC22A5, CPT2
4Isobutyryl-CoA259.5ACADVL, ACADS, SCD
5Hexanoyl-CoA259.5ACADVL, ACADS, SCD
6Glutaconyl-CoA259.5SCD, ACADS, ACADVL
7Undecanoyl-CoA259.5SCD, ACADVL, ACADS
8Decanoyl-CoA (n-C10:0CoA)259.5ACADVL, SCD, ACADS
9Butyryl-CoA259.5SCD, ACADS, ACADVL
10Pentanoyl-CoA259.5SCD, ACADS, ACADVL
11Tetracosanoyl-CoA259.5ACADVL, ACADS, SCD
12trans-Octadec-2-enoyl-CoA259.5ACADVL, ACADS, SCD
13Nonanoyl-CoA259.5SCD, ACADVL, ACADS
14Isovaleryl-CoA259.5ACADVL, ACADS, SCD
15Lauroyl-CoA259.5ACADVL, ACADS, SCD
162-methylbutyryl-coa46 2510.5SCD, ACADS, ACADVL
172-Methylhexanoyl-CoA259.5ACADVL, ACADS, SCD
18Eicosanoyl-CoA259.5ACADVL, SCD, ACADS
19octanoyl-coa46 2510.5SCD, ACADVL, ACADS
203Z-dodecenoyl-CoA259.5ACADVL, ACADS, SCD
21(2E)-Decenoyl-CoA259.5ACADS, ACADVL, SCD
22(2E)-Dodecenoyl-CoA259.5ACADVL, ACADS, SCD
23trans-2-Hexenoyl-CoA259.4SCD, ACADS, ACADVL
24Pristanoyl-CoA259.4ACADVL, ACADS, SCD
25Crotonoyl-CoA259.4ACADS, SCD, ACADVL
26(2E)-Octenoyl-CoA259.4SCD, ACADS, ACADVL
27(2E)-Tetradecenoyl-CoA259.4ACADVL, ACADS, SCD
28Acrylyl-CoA259.4ACADVL, ACADS, SCD
29stearoyl-coa46 2510.4SCD, ACADVL, ACADS
30(2E)-Hexadecenoyl-CoA259.4ACADS, ACADVL, SCD
31Propionyl-CoA259.4ACADS, ACADVL, SCD
32Heptanoyl-CoA259.4SCD, ACADVL, ACADS
33TG(18:1(9Z)/20:1(11Z)/20:1(11Z))[iso3]259.3CPT2, PNPLA2
34TG(20:0/20:1(11Z)/20:1(11Z))[iso3]259.2CPT2, PNPLA2
35TG(16:0/20:0/20:1(11Z))[iso6]259.2PNPLA2, CPT2
36TG(16:0/18:0/18:0)[iso3]259.1PNPLA2, CPT2
37TG(18:0/20:0/20:1(11Z))[iso6]259.1CPT2, PNPLA2
38choline46 25 1211.0SLC22A5, ETFDH, CPT2
39TG(16:1(9Z)/18:0/20:4(5Z,8Z,11Z,14Z))[iso6]259.0CPT2, PNPLA2
40Heptadecanoyl CoA259.0ACADVL, ACADS, PNPLA2, SCD
41palmitate468.9CPT2, ACADVL, SCD
42FAD258.9ETFDH, ACADS, ETFB, ACADVL
43s-adenosylmethionine46 25 1210.9ACADS, ACADVL, CPT2
44TG(18:0/18:0/18:0)258.8CPT2, PNPLA2
45carnitine468.7SLC22A5, CPT2, ACADVL, ACADS
46Palmityl-CoA258.7SCD, CPT2, ACADS, ACADVL
47acetyl-coa46 259.7SCD, ACADS, ACADVL, CPT2
48lipid467.8ACADVL, ACADS, CPT2, ABHD5, PNPLA2, SCD
49acyl-coa467.8CPT2, ACADVL, ETFDH, ACADS, ETFB, SCD
50fatty acid467.7ACADVL, SCD, ETFDH, ACADS, CPT2, PNPLA2

GO Terms for genes affiliated with Systemic Primary Carnitine Deficiency Disease

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17Gene Ontology
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Cellular components related to Systemic Primary Carnitine Deficiency Disease according to GeneCards/GeneDecks:

idNameGO IDScoreTop Affiliating Genes
1mitochondrial membraneGO:0319669.5ACADS, ETFDH
2lipid particleGO:0058119.3PNPLA2, ABHD5
3intracellular membrane-bounded organelleGO:0432319.1PNPLA2, ETFB, ABHD5
4mitochondrial matrixGO:0057598.5ETFDH, ACADVL, ACADS, ETFB
5mitochondrionGO:0057398.1CPT2, ETFB, ACADS, ACADVL

Biological processes related to Systemic Primary Carnitine Deficiency Disease according to GeneCards/GeneDecks:

(show all 8)
idNameGO IDScoreTop Affiliating Genes
1negative regulation of sequestering of triglycerideGO:0108919.6PNPLA2, ABHD5
2positive regulation of triglyceride catabolic processGO:0108989.6PNPLA2, ABHD5
3respiratory electron transport chainGO:0229049.5ETFB, ETFDH
4triglyceride catabolic processGO:0194339.3PNPLA2, ABHD5
5fatty acid beta-oxidation using acyl-CoA dehydrogenaseGO:0335399.1ACADS, ETFDH, ACADVL
6fatty acid beta-oxidationGO:0066358.7ACADVL, ACADS, CPT2
7cellular lipid metabolic processGO:0442558.5CPT2, ACADS, ACADVL
8small molecule metabolic processGO:0442816.9ETFDH, ETFB, CPT2, ACADVL, PNPLA2, ABHD5

Molecular functions related to Systemic Primary Carnitine Deficiency Disease according to GeneCards/GeneDecks:

idNameGO IDScoreTop Affiliating Genes
1electron carrier activityGO:0090559.5ETFB, ETFDH
2acyl-CoA dehydrogenase activityGO:0039959.3ACADVL, ACADS
3triglyceride lipase activityGO:0048069.3PNPLA2, ABHD5
4flavin adenine dinucleotide bindingGO:0506608.9ACADVL, ACADS, ETFDH

Products for genes affiliated with Systemic Primary Carnitine Deficiency Disease

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  • Antibodies
  • Proteins
  • Lysates
  • Antibodies

Sources for Systemic Primary Carnitine Deficiency Disease

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4CDC
14ExPASy
15FMA
23GTR
24HGMD
25HMDB
26ICD10
27ICD10 via Orphanet
28ICD9CM
30IUPHAR
31KEGG
36MeSH
37MESH via Orphanet
38MGI
41NCIt
42NDF-RT
45NINDS
46Novoseek
48OMIM
49OMIM via Orphanet
53PubMed
54QIAGEN
60SNOMED-CT via Orphanet
63UMLS
64UMLS via Orphanet