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Primary carnitine deficiencyA rare treatable cause of cardiomyopathy and massive hepatomegaly

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Elimination occurs primarily through renal excretion of metabolites, with the peptide and its fragments detectable in urine for up to 4 days following administration despite plasma clearance within hours

or a family history Of medullary thyroid carcinoma

Noninvasive tests are now standard in hepatology, but remain underused in primary care, endocrinology, and cardiology where many patients with advanced fibrosis are actually managed