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A milder, less common type happens in older infants and children Most patients with CACT Deficiency Disorder have a severe disease presenting within the first 48 hours of life as low blood sugar with ketonic bodies (hypoketotic hypoglycemia), high ammonia (hyperammonemia) levels in the blood, increased heart muscle (cardiomyopathy), and abnormal heart rhythm (arrhythmias), as well as skeletal muscle damage, liver problems, and low temperature (hypothermia) Neurological involvement, seizures, and developmental delay are also present

Table 1 Case description of patient A and patient B

While excessive water intake may temporarily dilute urine, laboratories routinely assess dilution using specimen validity testing

We have to be vigilant about making sure our children are staying hydrated and giving them breaks from the sun, particularly during the peak hours of the early afternoon, Dr

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