Summary
We report 8 cases of severe cytochromec oxidase deficiency with onset in the neonatal period. Clinical symptoms were heterogeneous: antenatal cerebral malformations, neurological distress with ketoacidosis, severe myopathy, or isolated respiratory control failure. Lactic acid was elevated in blood and/or CSF in 7 cases. Muscle biopsy (7 patients), liver biopsy (4 patients), and cultured skin fibroblasts (7 patients) were used to assess the cytochromec oxidase deficiency. Among the patients, the enzymatic defect differed in the level of residual activity, expression in different tissues and subunit composition in muscle (as analysed by immunohistochemistry). Southern blot analysis of the mitochondrial DNA was normal in 7 patients. The heterogeneity of cytochromec oxidase deficiency was therefore demonstrated by these clinical presentations and by the biochemical assessment of the enzyme defect. This reflects, most probably, the diverse nature of the causal mutations.
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Bresolin N, Zeviani M, Bonilla E, et al (1985) Fatal infantile cytochromec oxidase deficiency: decrease of immunologically detectable enzyme in muscle.Neurology 35: 802–812.
DiMauro S, Mendell JR, Sahenk A, et al (1980) Fatal infantile mitochondrial myopathy and renal dysfunction due to cytochromec oxidase deficiency.Neurology 30: 795–804.
DiMauro S, Nicholson JF, Hays AP, et al (1983) Benign infantile mitochondrial myopathy due to reversible cytochromec oxidase deficiency.Ann Neurol 14: 226–234.
DiMauro S, Lombes A, Nakase H, et al (1990) Cytochromec oxidase deficiency.Pediatr Res 28: 536–541.
Dubowitz V, Brooke MH (1973)Muscle Biopsy: A Modern Approach. Philadelphia: W.B. Saunders.
Heimann-Patterson T, Bonilla E, DiMauro S, Foreman J, Schotland DS (1982) Cytochromec oxidase deficiency in a floppy infant.Neurology 32: 898–900.
Kadenbach B, Stroh A, Becker A, Eckerskorn C, Lottspeich F (1989) Tissue- and species-specific expression of cytochromec oxidase isozymes in vertebrates.Biochim Biophys Acta 1015: 368–372.
Koch HG, Ullrich K, Deufel T, et al (1995) Benign neonatal lactic acidosis due to selective absence of nuclear encoded subunits VIIb,c of cytochromec oxidase. Poster presentation at the 33rd Annual Symposium of the SSIEM, Toledo, Spain, 1995.
Minchom PE, Dormer RL, Hughes IA, et al (1983) Fatal infantile mitochondrial myopathy due to cytochromec oxidase deficiency.J Neurol Sci 60: 453–463.
Moraes CT, Shanske S, Tritschler HJ, et al (1991) mtDNA depletion with variable tissue expression: a novel genetic abnormality in mitochondrial diseases.Am J Hum Genet 48: 492–501.
Müller-Höcker J, Pongratz D, Deufel T, Trijbels JMF, Endres W, Hübner G (1983) Fatal lipid storage myopathy with deficiency of cytochromec oxidase and carnitine.Virchows Arch 399: 11–23.
Müller-Höcker J, Droste M, Kadenbach B, Pongratz D, Hübner G (1989) Fatal mitochondrial myopathy with cytochromec-oxidase deficiency and subunit-restricted reduction of enzyme protein in two siblings: an autopsy—immunohistochemical study.Hum Pathol 20: 666–672.
Possekel S, Lombès A, Ogier de Baulny H, et al (1995) Immunohistochemical analysis of muscle cytochromec oxidase deficiency in children.Histochemistry 103: 59–68.
Rustin P, Chretien D, Bourgeron T, et al (1994) Biochemical and molecular investigations in respiratory chain deficiencies.Clin Chim Acta 228: 35–51.
Sengers RCA, Trijbels JMF, Bakkeren JAJM, et al (1983) Deficiency of cytochromeb andaa3 in muscle from a floppy infant with cytochrome oxidase deficiency.Eur J Pediatr 141: 178–180.
Servidei S, Bertini E, Dionisi-Vici C, et al (1988) Benign infantile mitochondrial myopathy due to reversible cytochromec oxidase deficiency: a third case.Clin Neuropathol 7: 209–210.
Tritschler H-J, Bonilla E, Lombes A, et al (1991) Differential diagnosis of fatal and benign cytochromec oxidase-deficient myopathies of infancy: an immunohistochemical approach.Neurology 41: 300–305.
Van Biervliet JPAM, Bruinvis L, Ketting D, et al (1977) Hereditary mitochondrial myopathy with lactic acidemia, a DeToni-Franconi-Debre syndrome, and a defective respiratory chain in voluntary striated muscles.Pediatr Res 11: 1088–1093.
Wallace DC (1992) Diseases of the mitochondrial DNA.Annu Rev Biochem 61: 1175–1212.
Zeviani M, Nonaka I, Bonilla E, et al (1985) Fatal infantile mitochondrial myopathy and renal dysfunction due to cytochromec oxidase deficiency: immunological studies in a new patient.Ann Neurol 17: 414–417.
Zeviani M, Peterson P, Bonilla E, DiMauro S (1987) Benign reversible muscle cytochromec oxidase deficiency. A second case.Neurology 37: 64–67.
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Lombes, A., Romero, N.B., Touati, G. et al. Clinical and molecular heterogeneity of cytochromec oxidase deficiency in the newborn. J Inherit Metab Dis 19, 286–295 (1996). https://doi.org/10.1007/BF01799256
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DOI: https://doi.org/10.1007/BF01799256