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For this purpose, 4-chloro-3-hydroxybutyronitrile is synthesized from epichlorohydrin in an aqueous hydrogen cyanide solution, 4-chloro-3-hydroxy butyric acid alkyl ester is then synthesized from the 4-chloro-3-hydroxybutyronitrile in the presence of an alcohol and a sulfuric acid catalyst, and the racemic 4-chloro-3 -hydroxy butyric acid alkyl ester is hydrolyzed in an aqueous solution using an enzyme, thereby preparing (R)-4-chloro-3-hydroxy butyric acid alkyl ester

[DOI] [PMC free article] [PubMed] [Google Scholar] 29.Ogborn D, Schoenfeld BJ

It is characterized by severe disabling fatigue and a spectrum of symptoms highlighted by self-reported attention and short-term memory impairments, sleep disturbances, and musculoskeletal pain