Benign infantile mitochondrial myopathy due to reversible cytochrome c oxidase deficiency
Insights
This study describes a rare case of reversible cytochrome c oxidase deficiency in an infant. The infant showed significant improvement, with enzyme activity normalizing over time.
Area of Science:
- Biochemistry
- Pediatrics
- Mitochondrial Diseases
Background:
- Cytochrome c oxidase (COX) deficiency is a severe mitochondrial disorder.
- The infantile form is typically fatal, presenting with profound weakness and lactic acidosis.
Observation:
- A 2-week-old infant presented with severe hypotonia, macroglossia, and lactic acidosis.
- Muscle biopsies revealed mitochondrial abnormalities and severely reduced COX activity.
- The infant demonstrated remarkable spontaneous clinical and biochemical recovery by 36 months.
Findings:
- Muscle biopsy and biochemical analyses confirmed an isolated COX deficiency.
- Histochemical COX staining and enzyme activity progressively normalized.
- This contrasts with the fatal infantile form, suggesting a reversible enzyme defect.
Implications:
- This case highlights a potentially reversible form of COX deficiency.
- Understanding the biochemical basis of this reversibility is crucial.
- Further research may lead to novel therapeutic strategies for mitochondrial disorders.
Abstract:
A 2-week-old boy had profound generalized weakness, hypotonia, hyporeflexia, macroglossia, and severe lactic acidosis. The infant improved spontaneously: he held his head at 4 1/2 months, rolled over at 7 months, and walked by 16 months. At 33 months of age, he had mild proximal weakness. Macroglossia disappeared by age 4 months. Blood lactic acid declined steadily and was normal by 14 months of age. Histochemical and ultrastructural studies of muscle biopsy specimens obtained at 1 and 7 months of age showed excessive mitochondria, lipid, and glycogen; a third biopsy at age 36 months showed only atrophy of scattered fibers. Cytochrome c oxidase stain was positive in fewer than 5% of fibers in the first biopsy, in approximately 60% of fibers in the second biopsy, and in all fibers in the third biopsy. Biochemical analysis showed an isolated defect of cytochrome c oxidase activity, which was only 8% of the lowest control level in the first biopsy; the activity increased to 47% in the second biopsy and was higher than normal in the third. In contrast to that in the fatal infantile form of cytochrome c oxidase deficiency, the enzyme defect in this condition is reversible. The biochemical basis for this difference remains to be explained.
Related Concept Videos
Mitochondrial Membranes
The Inner Mitochondrial Membrane
Electron Transport Chain: Complex I and II
ROS generation is regulated and maintained at moderate levels necessary...
ATP Synthase: Mechanism
The Electron Transport Chain
Inhibitors of the electron transport chain
Rotenone, a widely used pesticide, prevents electron transfer from Fe-S cluster to ubiquinone or Q in...
Electron Transport Chain: Complex III and IV


