Given the current knowledge of the genetic etiology underlying MADD, we suggest a stepwise approach for patients suspected of having MADD, involving targeted sequencing of ETFA, ETFB, and ETFDH followed by WES if targeted sequencing is negative.[5] MADD are multisystem genetic diseases characterized by various clinical manifestations with different degrees of severity. This evidence concerns the gene ETFB and multiple acyl-CoA dehydrogenase deficiency.