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For these patients, specialized lasers must be utilized, the most advanced of which is the GentleYAG Nd:YAG laser

PLoS One 12, e0178699

Tarozzi A, et al

Obstetrics gynecology Clinics North America

The metabolic derangements incorporate PDHC and TCA cycle defects: increased blood lactate and pyruvate, elevated plasma alanine, BCAA, presence of allo-isoleucine in plasma, and increased urinary lactic, pyruvic, 2-ketoglutaric, and branched-chain 2-hydroxy- and 2-ketoacid [143,144]