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Kidney disease, especially with dialysis

As a consequence, if the screening is done too early in life, plasma carnitine levels can falsely be above the cut-off in an infant with primary carnitine deficiency and drop below the cut-off over time (States mandating 2 screens where the second screening is usually collected between 7 and 21 days of age might better identify infants with primary carnitine deficiency, although no data in this respect have been published)

Apart from C0, low cutoff values have not been defined for the acylcarnitine species, relying heavily on a single metabolite (C0) for the identification of patients at risk for primary carnitine deficiency