FH and Encephalopathy: Homozygous FH deficiencies result in fumaric aciduria [17], characterized by early onset of severe encephalopathy and psychomotor retardation; on the contrary, heterozygous FH mutations predispose to multiple cutaneous and uterine leiomyomas (MCUL), as well as to hereditary leiomyomatosis and renal cell cancer (HLRCC) [18, 19].