This potentially catastrophic complication (frequently triggered by anaerobic overexertion or fasting) is also a typical feature of a long-chain fatty-acid oxidation disorder (carnitine palmitoyltransferase CPT2 deficiency), under the disorders of fatty acid and ketone body metabolism (ICIMD group 4). The gene discussed is CPT2; the disease is hyperinsulinemic hypoglycemia, familial, 4.