Patients with VLCAD deficiency had hypoglycemia (n = 2), rhabdomyolysis (n = 2), cardiomyopathy (n = 1), myalgia (n = 1), myopathy (n = 1), lethargy (n = 1), hypotonia (n = 1), and lactic acidemia (n = 1). This evidence concerns the gene ACADVL and hyperinsulinemic hypoglycemia, familial, 4.