 This disorder can be mistaken for Reye syndrome because of the symptoms of vomiting, lethargy, and convulsions.Mutations in the "HMGCL" gene cause 3-hydroxy-3-methylglutaryl-CoA lyase deficiency (HMGCLD), a rare autosomal recessive inborn error of metabolism characterized by disruption of ketogenesis and L-leucine catabolism.To-date more than 30 different mutations including missense mutations of different residues have been associated with patients with HMGCLD in diverse families and ethnicities.