A full term female infant failed to gain weight and showed metabolic acidosis in the neonatal period

Metabolic acidosis, elevation of blood pyruvate, lactate and alanine, all signify the nonconversion of pyruvate to acteyl CoA…The persistent metabolic acidosis is due to accumulation of lactates in blood.

Increased lactate and pyruvate levels.
Increased alanine levels in serum and urine.
Definitive diagnosis-Enzyme assay…Functional assays in leucocytes, fibroblasts
MRI shortly after birth reveal ventricular dilation, cerebral atrophy

Cofactor supplementation with thiamine, carnitine, lipoic acid