GPT and multiple acyl-CoA dehydrogenase deficiency: The clinical manifestations of MADD in children include myasthenia, enlarged liver, paroxysmal hypoglycemia, hypertrophic cardiomyopathy and rash during onset of the disease, while laboratory biochemical tests may show increased AST, ALT, CK, CK-MB and lactate dehydrogenase (LDH) levels and metabolic acidosis.