treatment

Last reviewed 01/2018

Maintenance:

  • manipulation of protein intake to remove precursors decreases propionic acid production. Often affected children have chronically poor appetites and require an enteral feeding tube
  • regular carnitine restores free coenzyme A levels and facilitates renal excretion of propionic acid
  • intermittent administration of oral metronidazole decreases the production of propionic acid by gut flora

Acute metabolic decompensation:

  • high carbohydrate, protein free feed - either a carbohydrate energy supplement such as Maxijul, or IV 10% Dextrose
  • administration of sodium benzoate and/or sodium phenylbutyrate provides alternative pathways for excretion of nitrogen