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Fatal infantile mitochondrial cardiomyopathy and myopathy with heterogeneous tissue expression of combined respiratory chain deficiencies

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Summary

A 5-month-old boy died of progressive heart failure that started at the age of 3 months. Autopsy revealed a mitochondrial cardiomyopathy and a mitochondrial myopathy of the limb muscle and diaphragm. Cytochemically random defects of cytochromec oxidase were visualized by light and electron microscopy in the diaphragm and especially the heart muscle, the limb muscle showing a diffuse attenuation whereas the liver and kidneys reacted normally. The activities of NADH-dehydrogenase (complex I) and cytochromec oxidase (complex IV) were severely diminished (20% residual activity of controls) in the skeletal and heart muscle. In the heart, succinate cytochromec reductase (complex II/III) was additionally decreased to the same degree. Loss of cytochromec oxidase activity was based on a reduction of both mitochondrial and nuclear derived subunits in the heart and diaphragm as revealed by immunohistochemical analysis, whereas the limb muscle showed a normal immunoreactive protein content. The results illustrate heterogeneous tissue expression of respiratory chain enzyme defects and demonstrate that a cardiomyopathy may be the leading presentation of a mitochondrial disorder in early infancy.

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Authors and Affiliations

  1. Pathologisches Institut, Munich, Germany

    J. Müller-Höcker, J. M. Gokel & G. Hübner

  2. Universitäts-Kinderklinik, Munich, Germany

    H. Ibel, T. Deufel & W. Endres

  3. Universität München, Munich, Germany

    H. Ibel, T. Deufel & W. Endres

  4. Klinisch-Chemisches Institut Städtisches Krankenhaus, Munich (Schwabing), Germany

    I. Paetzke

  5. Fachbereich Chemie, Universität Marburg, Marburg, Germany

    B. Kadenbach

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  1. J. Müller-Höcker
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  2. H. Ibel
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  3. I. Paetzke
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  4. T. Deufel
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  5. W. Endres
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  6. B. Kadenbach
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  7. J. M. Gokel
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  8. G. Hübner
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Müller-Höcker, J., Ibel, H., Paetzke, I. et al. Fatal infantile mitochondrial cardiomyopathy and myopathy with heterogeneous tissue expression of combined respiratory chain deficiencies. Vichows Archiv A Pathol Anat 419, 355–362 (1991). https://doi.org/10.1007/BF01606527

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