a case of pyruvate carboxylase deficiency with longer survival and normal laboratory findings.

Pyruvate carboxylase deficiency (pcd) is a rare autosomal recessive defect in a biotin-containing enzyme, pyruvate carboxylase, which is considered as an enzyme of tca-cycle regulation, gluconeogenesis, lipogenesis, and biosynthesis of neurotransmitters. increased lactate to pyruvate ratio and decreased three hydroxybutyrates to acetoacetate are the main biochemical features of pcd. the elevated level of citrulline, proline, and lysine with a short life span has been reported previously. patients’ survival in almost all cases is below three months. here, the authors aimed to report a girl with manifestations of type b of pcd and longer survival (two-year and four-month-old). this patient did not have any changes in amino acid level, which was a unique case of type b of pcd.