Skip to main content
Log in

Therapy of mitochondrial disorders

  • Section IV: Mitochondrial Defects — Diagnosis And Treatment
  • Published:
Journal of Inherited Metabolic Disease

Abstract

Mitochondrial disorders, namely defects of fatty acid oxidation, defects of pyruvate metabolism and defects of the respiratory chain are heterogenous in clinical picture and in response to therapeutic attempts. Defects of fatty acid metabolism are amenable to therapy by dietary means, carnitine substitution and in some cases with vitamins. Defects in pyruvate metabolism do not respond to therapy except in some special cases. Therapeutic attempts include dietary measures, vitamins as coenzyme precursors. Defects in the respiratory chain appear to respond to treatment only in exceptional cases. Evaluation of treatment effects appears to be singularly difficult. General measures that can be of benefit to different defects are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Arts, W. F. M., Scholte, H. R., Bogaard, J. M., Kerrebijn, K. F. and Luyt-Houwen, I. E. M. NADH-CoQ reductase deficient myopathy: successful treatment with riboflavine.Lancet 2 (1983) 581–582

    PubMed  Google Scholar 

  • Atkin, B. M., Buist, N. R. M., Utter, M. F., Leiter, A. B. and Banker, B. Q. Pyruvate carboxylase deficiency and lactic acidosis in a retarded child without Leigh's disease.Pediatr. Res. 13 (1979) 109–116

    PubMed  Google Scholar 

  • Baal, M. G., Gabreëls, F. J. M., Renier, W. O., Hommes, F. A., Gijsbers, Th. H. J., Lamers, K. J. B. and Kok, J. C. N. A patient with pyruvate carboxylase deficiency in the liver: treatment with aspartic acid and thiamine.Dev. Med. Child Neurol. 23 (1981) 521–530

    PubMed  Google Scholar 

  • Bank, W. J., Di Mauro, S., Bonilla, E., Capuzzi, D. M. and Rowland, L. P. A disorder of muscle lipid metabolism and myoglobinuria.N. Engl. J. Med. 292 (1975) 443–449

    PubMed  Google Scholar 

  • v. Biervliet, J. P. G. M., Bruinvis, L., v. d. Heiden, C., Ketting, D., Wadman, S. K., Willemse, J. L. and Monnens, L. A. H. Report of a patient with severe, chronic lactic acidaemia and pyruvate carboxylase deficiency.Dev. Med. Child Neurol. 19 (1977) 392–401

    PubMed  Google Scholar 

  • Blass, J. P., Kark, R. A. P. and Engel, W. K. Clinical studies of a patient with pyruvate decarboxylase deficiency.Arch. Neurol. 25 (1971) 449–460

    PubMed  Google Scholar 

  • Bougnères, P. F., Saudubray, J. M., Marsac, C., Bernard, O., Odièvre, M. and Girard, J. Fasting hypoglycemia resulting from hepatic carnitine palmitoyl transferase deficiency.J. Pediatr. 98 (1981) 742–746

    PubMed  Google Scholar 

  • Brunette, M. G., Delvin, E., Hazel, B. and Scriver, C. R. Thiamine responsive lactic acidosis in a patient with deficient lowK m pyruvate carboxylase activity in liver.Pediatrics 50 (1972) 702–711

    PubMed  Google Scholar 

  • Cederbaum, S. D., Blass, J. P., Minkoff, N., Brown, W. J., Cotton, M. E. and Harris, S. H. Sensitivity to carbohydrate in a patient with familial intermittent lactic acidosis and PDH deficiency.Pediatr. Res. 10 (1976) 713–720

    PubMed  Google Scholar 

  • Crabb, D. W., Yount, E. A. and Harris, R. A. The metabolic effects of dichloroacetate.Metabolism 30 (1981) 1024–1039

    PubMed  Google Scholar 

  • Cumming, W. J. K., Hardy, M., Hudgson, P. and Walls, J. Carnitine palmityl transferase deficiency.J. Neurol. Sci. 30 (1976) 247–258

    PubMed  Google Scholar 

  • Di Donato, S., Rimoldi, M., Moise, A., Bertagnoglio, B. and Uzil, G. Fatal ataxic encephalopathy and carnitine acetyl transferase deficiency a functional defect of pyruvate oxidation?Neurology 29 (1979) 1578–1583

    PubMed  Google Scholar 

  • Eleff, S., Kennaway, N. G., Buist, N. R. M., Darley-Usmar, V. M., Capaldi, R. A., Bank, W. J. and Chance, B.31P NMR study of improvement in oxidative phosphorylation by vitamins K3 and C in a patient with a defect in electron transport at complex III in skeletal muscle.Proc. Natl. Acad. Sci. USA 81 (1984) 3529–3533

    PubMed  Google Scholar 

  • French, J. H., Sherard, E. S., Lubell, H., Brotz, M. and Moore, C. L. Trichopoliodystrophy. I. Report of a case and biochemical studies.Arch. Neurol. 26 (1972) 229–244

    PubMed  Google Scholar 

  • Gregersen, N., Christensen, M. F., Christensen, E. and Kolvraa, S. Riboflavine responsive multiple acyl-CoA dehydrogenation deficiency.Acta Pediatr. Scand. 75 (1986) 676–681

    Google Scholar 

  • Harpey, J. P., Charpentier, C. and Coudé, M. Methylene blue for riboflavin-unresponsive glutaric aciduria type II.Lancet 1 (1986) 391

    PubMed  Google Scholar 

  • Hayes, D. J., Hilton-Jones, D., Arnold, D. L., Galloway, G., Styles, P., Duncan, J. and Radda, G. K. A mitochondrial encephalomyopathy. A combined31P magnetic resonance and biochemical investigation.J. Neurol. Sci. 71 (1985) 105–118

    PubMed  Google Scholar 

  • Hommes, F. A., Polman, H. A. and Reesink, J. D. Leigh's encephalomyelopathy: an inborn error in gluconeogenesis.Arch. Dis. Child. 43 (1968) 423–426

    PubMed  Google Scholar 

  • Jusko, W. J. and Levy, G. Absorption, protein binding and elimination of riboflavin. In Rivlin, R. S. (ed.)Riboflavin, Plenum Press, New York, 1975, pp. 99–152

    Google Scholar 

  • Maesaka, H., Komiya, K., Misugi, K. and Tada, K. Hyperalaninemia, hyperpyruvicemia and lactic acidosis due to pyruvate carboxylase deficiency of the liver; treatment with thiamine and lipoic acid.Eur. J. Pediatr. 122 (1976) 159–168

    PubMed  Google Scholar 

  • Matalon, R., Stumpf, D. A., Michals, K., Hart, R. D., Parks, J. K. and Goodman, S. I. Lipoamide dehydrogenase deficiency with primary lactic acidosis: favourable response to treatment with oral lipoic acid.J. Pediatr. 104 (1984) 65–69

    PubMed  Google Scholar 

  • McCormick, K., Viscardi, R. M., Robinson, B. and Heininger, J. Partial pyruvate decarboxylase deficiency with profound lactic acidosis and hyperammonemia: response to dichloroacetate and benzoate.Am. J. Med. Genet. 22 (1985) 291–299

    PubMed  Google Scholar 

  • McKay, N., Petrova-Benedict, R., Thoene, J., Bergen, B., Wilson, W. and Robinson, B. Lacticacidaemia due to pyruvate dehydrogenase deficiency, with evidence of protein polymorphism in the α-subunit of the enzyme.Eur. J. Pediatr. 144 (1986) 445–450

    PubMed  Google Scholar 

  • Mooy, P. D., Przyrembel, H., Giesberts, M. A. H., Scholte, H. R., Blom, W. and van Gelderen, H. H. Glutaric aciduria type II: treatment with riboflavin, carnitine and insulin.Eur. J. Pediatr. 143 (1984) 92–95

    PubMed  Google Scholar 

  • Morgan-Hughes, J. A., Hayes, D. J., Clark, J. B. and Cooper, J. M. Mitochondrial myopathies. Results of exploratory therapeutic trials. In Folkers, K. and Yamamura, Y. (eds.),Biochemical and Clinical Aspects of Coenzyme Q. Vol. 4, Elsevier Ssience Publishers, Amsterdam, 1984, pp. 417–424

    Google Scholar 

  • Munnich, A., Saudubray, J. M., Taylor, J., Charpentier, C., Marsac, J., Rocchiccioli, F., Amedee-Manesme, O., Coudé, F. X., Frézal, J. and Robinson, B. H. Congenital lactic acidosis, α-ketoglutaric aciduria and variant form of maple syrup urine disease due to a single enzyme defect: dihydrolipoyl dehydrogenase deficiency.Acta Paediatr. Scand. 71 (1982) 167–171

    PubMed  Google Scholar 

  • Ogasahara, S., Nishikawa, Y., Yorifuji, S., Soga, F., Nakamura, Y., Takahashi, M., Hashimoto, S., Kono, N. and Tarui, S. Treatment of Kearns-Sayre syndrome with coenzyme Q 10.Neurology 36 (1986) 45–53

    PubMed  Google Scholar 

  • Patten, B. M., Wood, J. M., Harati, Y., Hefferan, P. and Howell, R. R. Familial recurrent rhabdomyolysis due to carnitine palmityltransferase deficiency.Am. J. Med. 67 (1979) 167–171

    PubMed  Google Scholar 

  • Przyrembel, H. Carnitin: Bedeutung für Klinik, Diagnostik, Therapie.Akt. Endokr. Stoffw. 7 (1986) 9–17

    Google Scholar 

  • Reza, M. J., Kar, N. C., Pearson, C. M. and Kark, R. A. P. Recurrent myoglobinuria due to muscle carnitine palmityltransferase deficiency.Ann. Intern. Med. 88 (1978) 610–615

    PubMed  Google Scholar 

  • Robinson, B. H. and Sherwood, W. G. Pyruvate dehydrogenase phosphatase deficiency: a cause of congenital chronic lactic acidosis in infancy.Pediatr. Res. 9 (1975) 935–939

    PubMed  Google Scholar 

  • Robinson, B. H., Taylor, J., Kahler, S. G. and Kirkman, H. N. Lactic acidemia, neurologic deterioration and carbohydrate dependance in a girl with dihydrolipoyl dehydrogenase deficiency.Eur. J. Pediatr. 136 (1981) 35–39

    PubMed  Google Scholar 

  • Robinson, B. H., Taylor, J., Francois, B., Beaudet, A. L. and Peterson, D. F. Lacticacidosis, neurological deterioration and compromised cellular pyruvate oxidation due to a defect in the reoxidation of cytoplasmically generated NADH.Eur. J. Pediatr. 140 (1983) 98–101

    PubMed  Google Scholar 

  • Roe, C. R., Millington, D. S., Maltby, D. A., Bohan, T. P., Kahler, S. G. and Chalmers, R. A. Diagnostic and therapeutic implications of medium-chain acylcarnitines in the medium-chain acyl-CoA dehydrogenase deficiency.Pediatr. Res. 19 (1985) 459–466

    PubMed  Google Scholar 

  • Snyder, T. M., Little, B. W., Roman-Campos, G. and McQuillen, J. B. Successful treatment of familial idiopathic lipid storage myopathy withl-carnitine and modified lipid diet.Neurology 32 (1982) 1106–1115

    PubMed  Google Scholar 

  • Stacpoole, P. W., Harman, E. M., Curry, S. H., Baumgartner, T. G. and Misbin, R. I. Treatment of lactic acidosis with dichloroacetate.N. Engl. J. Med. 309 (1983) 390–396

    PubMed  Google Scholar 

  • de Visser, M., Scholte, H. R., Schutgens, R. B. H., Bolhuis, P. A., Luyt-Houwen, I. E. M., Vaandrager-Verduin, M. H. M., Veder, H. A. and Oey, P. L. Riboflavin-responsive lipid-storage myopathy and glutaric aciduria type II of early adult onset.Neurology 36 (1986) 367–372

    PubMed  Google Scholar 

  • de Vivo, D. C., Haymond, M. W., Leckie, M. P., Bussmann, Y. L., McDougal, D. B. and Pagliara, A. S. The clinical and biochemical implications of pyruvate carboxylase deficiency.J. Clin. Endocrinol. Metab. 45 (1977) 1281–1296

    PubMed  Google Scholar 

  • Warner, A. and Vaziri, N. D. Treatment of lactic acidosis.South. Med. J. 74 (1981) 841–847

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Przyrembel, H. Therapy of mitochondrial disorders. J Inherit Metab Dis 10 (Suppl 1), 129–146 (1987). https://doi.org/10.1007/BF01812853

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01812853

Keywords

Navigation