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There were 16 different (likely) pathogenic variants identified of which 11 have not been reported previously (depicted in light grey)

However, nothing suggests that the topical use of L-carnitine poses a danger for these groups

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[PubMed: 22466137] (Analysis of California Poison Control database [2001-2010] for cases of prescription acetaminophen overdose with hepatic injury identified 40 cases [2 deaths, 1 liver transplant], most commonly with combinations of 500 mg of acetaminophen with hydrocodone or oxycodone and often with addition of an over-the-counter acetaminophen product)

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However, the history gives a bit of a clue in that she had similar, albeit nonspecific, signs a few months ago so this might be chronic pancreatitis