The correct option is D. Reduced spleen
A. Precocious puberty – Some metabolic disorders (e.g., congenital adrenal hyperplasia) can lead to early puberty due to enzyme deficiencies affecting steroid metabolism.
B. Myocardial infarction – Certain metabolic disorders (e.g., homocystinuria, familial hypercholesterolemia) can cause premature atherosclerosis, leading to early heart attacks.
C. Thrombocytopenia – Some IEMs, such as Gaucher disease or methylmalonic acidemia, can lead to hematological abnormalities, including low platelet counts.
D. Reduced spleen – While some metabolic disorders can lead to splenomegaly (enlarged spleen) due to storage diseases (e.g., Gaucher disease, Niemann-Pick disease), a reduced spleen (as in congenital asplenia or autosplenectomy) is not a typical manifestation of inborn errors of metabolism.
