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Start free with Eleplan3-hydroxy-3-methylglutaric aciduria
ORPHA:20Disease
Also called 3-hydroxy-3-methylglutaryl-CoA lyase deficiency · HMG-CoA lyase deficiency · Hydroxymethylglutaric aciduria
What it is
A rare organic aciduria, due to deficiency of 3-hydroxy-3-methylglutaryl-CoA lyase characterized by episodes of metabolic decompensation with hypoketotic hypoglycemia triggered by periods of fasting or infections.
Key facts
- Prevalence
- 1-9 / 1 000 000 (at birth, Portugal)
- Age of onset
- All ages
- Inheritance
- Autosomal recessive
- Classified as
- Disease
Prevalence figures describe populations, not individuals, and are often estimates from a single study. Where the figure is an incidence or a birth prevalence, it says so.
Signs and symptoms
Common30–79%
17- Anemia
- Anorexia
- Apathy
- EEG abnormality
- Elevated circulating hepatic transaminase concentration
- Episodic vomiting
- Hepatomegaly
- Hyperuricemia
- Hypotonia
- Increased circulating lactate concentration
- Lethargy
- Lipid accumulation in hepatocytes
- Prolonged prothrombin time
- Recurrent hypoglycemia
- Reye syndrome-like episodes
- Seizure
- Tachypnea
Sometimes5–29%
22and 14 more in this range
Rare1–4%
11- Acute pancreatitis
- Ataxia
- Cardiac arrest
- Dilated cardiomyopathy
- Dysarthria
- Hypoglycemic coma
- Hypothermia
- Leukoencephalopathy
and 3 more in this range
These ranges are how often a sign appears across everyone diagnosed, not a prediction for one person — most people have some of these and not others. Orphanet also records findings that are specifically absent in this disease; those are in the data but not listed here.
Gene
ICD-10 codes
ICD-10 has no distinct code for most rare diseases, so many are filed under the nearest available one. A shared code identifies the group, not this disease — the ORPHAcode above is what identifies it.
Related health topics
Reached through the ICD-10 categories this disease is filed under, so these describe the broader group rather than this disease specifically.
Cross-references
Orphadata Science: Free access data from Orphanet. © INSERM 1999. Data version 2026-06-23. Available under CC BY 4.0. This is a reference, not medical advice.
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