Article Guillain Barre syndrome HADHB MTP acetyl coenzyme A acyltransferase achilles reflex adult carnitine case report clinical article creatine kinase electromyography estrogen receptor alpha fatty acid oxidation female fever gastric bypass surgery gastroenteritis gene mutation giant axonal neuropathy hospitalization human human tissue lactic acid mitochondrial trifunctional protein muscle weakness mutation myoglobinuria neuromuscular system neuropathy