Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter February 14, 2018

Outcomes of mitochondrial derived diseases: a single-center experience

  • Sahin Erdol EMAIL logo and Halil Saglam

Abstract

Background:

The purpose of this study is to help elucidate which part of the mitochondria is causing a problem through anamnesis, physical examination, and routine biochemical tests in the event of a suspected mitochondrial disease case.

Methods:

The data were obtained retrospectively from the medical records of 75 cases; the mitochondrial-derived disease (MDD) cases were observed in our center from 2011 to 2017.

Results:

The most commonly observed MDDs were oxidative phosphorylation disorders at 44%, followed by fatty acid oxidation disorder at 40%, pyruvate metabolism disorder at 12%, and ketone metabolism disorder at 4%, respectively. The most common clinical presentation at the time of referral to the hospital was metabolic acidosis (20%), and the most common symptom was respiratory distress (24%). There were abnormal findings in 84.3% of the cases subjected to cranial magnetic resonance imaging (MRI), with the most common being hyperintensity in the bilateral basal ganglia (49.0%).

Conclusions:

Anamnesis, physical examination, and simple laboratory data could provide some important clues in assessing MDD. Blood gas should definitely be measured in cases with respiratory symptoms, particularly if they have a history of consanguineous marriage or a sibling suffering from a similar disease. If metabolic acidosis exists in the blood gas, MDDs should absolutely be included in the differential diagnosis. Furthermore, ophthalmic and cardiac assessment and cranial MRI will also reveal significant data for diagnosing MDDs.


Corresponding author: Sahin Erdol, MD, Uludag University Faculty of Medicine, Department of Pediatrics, Division of Metabolism, 16059 Gorukle, Bursa, Turkey, Phone: +90 224 2950546, Fax: +90 224 4428143

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Duchen MR. Mitochondria in health and disease: perspectives on a new mitochondrial biology. Mol Aspects Med 2004;25:365–451.10.1016/j.mam.2004.03.001Search in Google Scholar PubMed

2. Skladal D, Halliday J, Thornburn DR. Minimum birth prevalence of mitochondrial respiratory chain disorders in children. Brain 2003;126:1905–12.10.1093/brain/awg170Search in Google Scholar PubMed

3. Scaglia F, Towbin JA, Craigen WJ, Belmont JW, Smith EO, et al. Clinical spectrum, morbidity and mortality in 113 pediatric patients with mitochondrial disease. Pediatrics 2004;114:925–31.10.1542/peds.2004-0718Search in Google Scholar PubMed

4. Thornburn DR, Smeitink J. Diagnosis of mitochondrial disorders: clinical and biochemical approach. J Inherit Metab Dis 2001;24:312–6.10.1023/A:1010347808082Search in Google Scholar

5. Saudubray JM, Baumgartner MR, Walter J. Disorders of mitochondrial energy metabolism. In: Saudubray JM, Baumgartner MR, Walter J, editors. Inborn metabolic diseases, 6th ed. Berlin, Heidelberg: Springer, 2016:187–251.Search in Google Scholar

6. Bernier FP, Boneh A, Dennett X, Chow CW, Cleary MA, et al. Diagnostic criteria for respiratory chain disorders in adults and children. Neurology 2002;59:1406–11.10.1212/01.WNL.0000033795.17156.00Search in Google Scholar PubMed

7. Debray FG, Lambert M, Chevalier I, Robitaille Y, Decarie JC, et al. Long-term outcome and clinical spectrum of 73 pediatric patients with mitochondrial diseases. Pediatrics 2007;119: 722–33.10.1542/peds.2006-1866Search in Google Scholar PubMed

8. Honzik T, Tesarova M, Magner M, Mayr J, Jesina P, et al. Neonatal onset of mitochondrial disorders in 129 patients: clinical and laboratory characteristics and a new approach to diagnosis. J Inherit Metab Dis 2012;35:749–59.10.1007/s10545-011-9440-3Search in Google Scholar PubMed

9. Rocha V, Rocha D, Santos H, Marques JS. Growth hormone deficiency in a patient with mitochondrial disease. J Pediatr Endocrinol Metab 2015;28:1003–4.10.1515/jpem-2014-0315Search in Google Scholar PubMed

10. Skladal D, Sudmeier C, Konstantopoulou V, Stöckler-Ipsiroglu S, Plecko-Startinig B, et al. The clinical spectrum of mitochondrial disease in 75 pediatric patients. Clin Pediatr 2003;42:703–10.10.1177/000992280304200806Search in Google Scholar PubMed

11. Touati G, Rigal O, Lombès A, Frachon P, Giraud M, et al. In vivo functional investigations of lactic acid in patients with respiratory chain disorders. Arch Dis Child 1997;76:16–21.10.1136/adc.76.1.16Search in Google Scholar PubMed PubMed Central

Received: 2017-10-5
Accepted: 2017-11-22
Published Online: 2018-2-14
Published in Print: 2018-3-28

©2018 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 26.4.2024 from https://www.degruyter.com/document/doi/10.1515/jpem-2017-0405/html
Scroll to top button