PPM1K and metabolic disease: This paper posits that the primary challenge in managing MSUD lies in the prevention of metabolic crises through dietary control, aligning with Hassan & Gupta's definition of MSUD as an autosomal recessive metabolic disorder characterized by a deficiency in the BCKDH enzyme complex, which is necessary for the breakdown of the BCAAs isoleucine, leucine, and valine (3).