Hepatopathy and hepatomegaly as consequences of prolonged fasting or illnesses are typical clinical features of very long chain acyl-CoA dehydro-genase (VLCACD) deficiency, the most common long-chain fatty acid b-oxidationdefect. Supplementationwithmedium-chain triglycerides (MCTs) is an important treatment measure in these defects, in order to supply suffi-cient energy.