SLC25A13 and citrin deficiency: Considering that acetaminophen may trigger onset of CTLN2,[16] we suggested the use of ketorolac without hepatotoxic effect to relieve mild to moderate pain.[17] For relief of moderate to severe pain, short-term use of phenylpiperidine opioids such as fentanyl at reduced doses is more likely to avoid accumulation and adverse events than morphine.[6] The use of opioid in patients with citrin deficiency should be carefully titrated in order to minimize dose-dependent side effects and monitored for any sign of hepatic encephalopathy such as disturbance of consciousness.