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MADD is caused by deficiency of one of the two electron-transfer flavoproteins which transfer electrons from acyl-CoA dehydrogenases to Coenzyme Q in the respiratory chain: Electron Transfer Flavoprotein (ETF), encoded by ETFA and ETFB genes, and electron-transfer flavoprotein dehydrogenase (ETFDH), encoded by ETFDH [136]

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