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In page Carnitine palmitoyltransferase II deficiency:

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However, most researchers are reluctant to accept the existence of a causal relationship between enzyme functionality and clinical phenotype.[2] Two groups[3][4] have recently reported a limited correlation (lacking in statistical significance) between the genotypic array and the clinical severity of the phenotype in their patient cohorts. There is a need for further explorations of this topic in order to fully assess the biochemical ramifications of this enzymatic deficiency.[citation needed]