Introduction
Isovaleric acidemia (IVA) is an autosomal recessive disease
of leucine metabolism due to deficiency of isovaleryl-CoA
Dehydrogenase (IVD). Acute and chronic intermittent forms have
been described. Clinical manifestations in the acute form include
vomiting and severe acidosis in the first few days of life, followed
by progression to lethargy, convulsions, coma and death if proper
therapy is not initiated.