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Mitochondrial Myopathy

Presentation

This is supported by the reported cases of myoglobinuria in mitochondrial disorders. 4 A similar but slower mechanism may explain the relatively rapid presentation in our patient, as well as the subacute mode of presentation of other mitochondrial disorders [jnnp.bmj.com]

However, when they present in adolescence or adulthood, they tend to present with myopathic symptoms, cardiomyopathy symptoms, or both. 1 Adults may present with fatigue, proximal muscle weakness and soreness, exercise intolerance, 1 or ptosis. [jaoa.org]

It can present as an idiopathic proximal myopathy with very subtle neuropathic features. Alternately, it can present with ophthalmoplegia with very subtle myopathic changes. [onlinelibrary.wiley.com]

Complementary and alternative medicine Medicine(all) Cite this Apa Standard Harvard Vancouver BIBTEX RIS @article{4ea902ecd7be4c4d90d52ec63baaed35, title = "Mitochondrial myopathy presenting as Rhabdomyolysis", abstract = "A 37-year-old white woman presented [mayoclinic.pure.elsevier.com]

Trial evaluating treatment with elamipretide in rare disease meets efficacy and safety endpoints Data to be presented at Mitochondrial Medicine 2016 on Friday, June 17 at 8:10 a.m. [stealthbt.com]

Entire Body System

  • Epilepsy

    Rosing HS, Hopkins LC, Wallace DC, Epstein CM, Weidenheim K - Maternally inherited mitochondrial myopathy and myoclonic epilepsy. Ann Neurol 17:228, 1985. [ Links ] 41. Rustam H, Hamdi T, Witri S - Progressive familial myoclonus epilepsy. [scielo.br]

    Some of the more common mitochondrial myopathies include Kearns-Sayre syndrome, myoclonus epilepsy with ragged-red fibers, and mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes. [ninds.nih.gov]

    […] and ragged-red fibers (MERRF) Progressive myoclonic epilepsy Clumps of diseased mitochondria accumulate in muscle fibers and appear as "ragged-red fibers" when muscle is stained with modified Gömöri trichrome stain Short stature Kearns-Sayre syndrome [en.wikipedia.org]

    For instance, you can treat diabetes with tablets or insulin, epilepsy with anti-epilepsy medications, deafness with hearing aids (or in some cases, cochlear implants), heart rhythm problems with pacemakers. [musculardystrophyuk.org]

  • Asymptomatic

    The mother was asymptomatic. Two daughters had lactic acidosis and myoclonic epilepsy, mild dementia, ataxia, weakness and sensory neuropathy. The son suffered one acute hemiplegic episode due to an ischemic infarct in the right temporal region. [scielo.br]

    In some of the studies including patients with the m.3243A>G mutation, data from mutation carriers who were asymptomatic or paucisymptomatic were included, which could also have affected the results. 9, 12, 15, 24 This illustrates another limitation of [ng.neurology.org]

    Family history may be overlooked due to mild or oligosymptomatic disease, variability in clinical manifestations, or because many relatives may be asymptomatic carriers. [journals.sagepub.com]

Musculoskeletal

  • Myopathy

    Emery–Dreifuss Other structural collagen disease Bethlem myopathy PTP disease X-linked MTM adaptor protein disease BIN1-linked centronuclear myopathy cytoskeleton disease Nemaline myopathy Zaspopathy Channelopathy Myotonia Myotonia congenita Thomsen [en.wikipedia.org]

    Treatment Although there is no specific treatment for any of the mitochondrial myopathies, physical therapy may extend the range of movement of muscles and improve dexterity. [ninds.nih.gov]

    Is mitochondrial myopathy inherited? A proportion of cases of mitochondrial myopathy are not inherited from the parents. Instead changes to the mitochondrial DNA occur spontaneously after conception. [mda.org.au]

    We conclude that long-term therapy with zidovudine can cause a toxic mitochondrial myopathy, which coexists with a T-cell—mediated inflammatory myopathy that is restricted to MHC-I antigen, and is indistinguishable from the myopathy associated with primary [nejm.org]

  • Muscle Weakness

    During physical activity, muscles may become easily fatigued or weak. Muscle cramping is rare, but may occur. [ninds.nih.gov]

    […] paralysis of the muscles controlling eye movement Muscle weakness in the neck, arms or legs Numbness and weakness in the hands and feet (peripheral neuropathy) Difficulty swallowing Hearing loss Short stature Symptoms usually appear in childhood after [chop.edu]

    Speech Therapy Muscle weakness in the throat may make talking or swallowing difficult. Speech therapy may help strengthen the muscles or work around the weakness. Respiratory Therapy Respiratory therapy will help make sure breathing is normal. [lahey.org]

    Clinical features include muscle weakness, buildup of lactic acid in the muscles, and sideroblastic anemia, a form of anemia where red blood cells do not develop properly resulting in inefficient oxygen transport. [sema4.com]

  • Muscle Cramp

    Most mitochondrial myopathies occur before the age of 20, and often begin with exercise intolerance or muscle weakness. During physical activity, muscles may become easily fatigued or weak. Muscle cramping is rare, but may occur. [ninds.nih.gov]

    They often begin with muscle weakness. During physical activity, muscles may become easily fatigued or weak. Muscle cramping is rare, but may occur. [medicinenet.com]

Ears

  • Hearing Impairment

    Association between idiopathic hearing loss and mitochondrial DNA mutations: a study on 169 hearing-impaired subjects. Int J Mol Med. 2013 ;32: 785 - 794. Google Scholar | Crossref | Medline | ISI 13. Henning, F, Oey, PL, Oerlemans, WG, Wokke, JH. [journals.sagepub.com]

    The disease also can cause hearing impairment and short stature. [ninds.nih.gov]

Neurologic

  • Seizure

    Medications Medications may be needed for symptoms such as irregular heartbeat, seizures or pain. Prevention There are no current guidelines to prevent mitochondrial myopathies. [lahey.org]

    […] symptoms of mitochondrial myopathies include muscle weakness or exercise intolerance, heart failure or rhythm disturbances, dementia, movement disorders, stroke-like episodes, deafness, blindness, droopy eyelids, limited mobility of the eyes, vomiting, and seizures [ninds.nih.gov]

    Mitochondrial Myopathy Symptoms Generally, mitochondrial myopathies cause: Muscle weakness or exercise intolerance Lack of balance or coordination Arrhythmias of the heart or heart failure Problems with eye movements Seizures Stroke-like episodes Vomiting [uvahealth.com]

    Years later, her daughter, Rose, began suffering seizures. Tom is full of laughter and smiles, yet he has had a complicated medical history and has undergone over 35 medical procedures. [mito.org.au]

  • Encephalopathy

    lactic acidosis AND stroke C0162671 OMIM HP:0003737 HP:0003737 Mitochondrial myopathy 0 COX2 4513 550 Adenylosuccinate lyase deficiency C0268126 ORPHA HP:0003737 HP:0003737 Mitochondrial myopathy 0 COX2 4513 540000 Juvenile myopathy, encephalopathy, [mseqdr.org]

    Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS): a correlative study of the clinical features and mitochondrial DNA mutation. [ajnr.org]

    The individual conditions that compose mitochondrial myopathies include MELAS (mitochondrial encephalopathy, lactic acidosis and stroke-like episodes), PEO (progressive external ophthalmoplegia), KSS (Kearns-Sayre syndrome) and MERRF syndrome (myoclonic [neurovive.com]

    Background Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke (MELAS) syndrome is a multisystem and progressive neurodegenerative disorder. [emedicine.medscape.com]

    encephalopathy (MNGIE) Myoclonic epilepsy with ragged red fibers (MERFF) Neuropathy, ataxia and retinitis pigmentosa (NARP) syndrome Pearson syndrome Progressive external ophthalmoplegia (PEO) Mitochondrial myopathies may be caused by mutations in the [chop.edu]

  • Ataxia

    Leigh’s Syndrome; Mitochondrial DNA Depletion Syndrome; Mitochondrial Encephalomyopathy, Lactic Acidosis and Strokelike Episodes; Myoclonic Epilepsy Associated With Ragged Red Fibers; Mitochondrial Neurogastrointestinal Encephalopathy; Neuropathy, Ataxia [lahey.org]

    Mitochondrial DNA (mtDNA) depletion syndrome Mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome Mitochondrial neurogastrointestinal encephalopathy (MNGIE) Myoclonic epilepsy with ragged red fibers (MERFF) Neuropathy, ataxia [chop.edu]

    Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE): Occurs before age 20 Causes eye movement problems (PEO), drooping eyelid, limb weakness, digestive problems and peripheral neuropathy Neuropathy, ataxia, and retinitis pigmentosa (NARP): [uvahealth.com]

    Mitochondrial diseases can cause ataxia, which refers to trouble with balance and coordination. People with ataxia are prone to falls, and may need to use supportive aids such as railings, a walker, or a wheelchair. [ninds.nih.gov]

    Tatsumi C, Takahashi M, Yorifuii S, Kitagichi M, Tarui S - Mitochondrial encephalomyopathy, ataxia, and sleep apnea. Neurology 37:1429, 1987. [ Links ] 47. [scielo.br]

  • Peripheral Neuropathy

    neuropathy) If mitochondrial myopathy is suspected based on the patient’s physical symptoms and history, additional tests are performed to make a diagnosis. [chop.edu]

    neuropathy Neuropathy, ataxia, and retinitis pigmentosa (NARP): Occurs in early childhood or adulthood Causes uncoordinated muscle movement (ataxia) and degeneration of the retina in the eye, leading to loss of vision Pearson’s syndrome: Occurs in infancy [uvahealth.com]

    neuropathy Neuropathy, ataxia, and retinitis pigmentosa (NARP) Early childhood to adulthood Uncoordinated muscle movement (ataxia), degeneration of the retina in the eye leading to loss of vision Pearson’s syndrome Infancy Causes severe anemia and pancreas [lahey.org]

    Our other pipeline candidates include SBT-272, which we are evaluating for rare neurodegenerative disease indications, and SBT-20, which we are evaluating for rare peripheral neuropathies. [prnewswire.com]

  • Chronic Progressive External Ophthalmoplegia

    The most common MD are Leber's Hereditary Optic Neuropathy (LHON), Chronic Progressive External Ophthalmoplegia (CPEO), Kearns-Sayre Syndrome (KSS), Mitochondrial Myopathy (MM) and Mitochondrial Encephalomyopathy, Lactic Acidosis and Strokelike episodes [ncbi.nlm.nih.gov]

    […] in muscle fibers and appear as "ragged-red fibers" when muscle is stained with modified Gömöri trichrome stain Short stature Kearns-Sayre syndrome (KSS) External ophthalmoplegia Cardiac conduction defects Sensorineural hearing loss Chronic progressive [en.wikipedia.org]

    There are several different types, including: Kearns-Sayre syndrome (KSS) chronic progressive external ophthalmoplegia (CPEO) Leber hereditary optic neuropathy (LHON) mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) myoclonus [musculardystrophyuk.org]

    progressive external ophthalmoplegia [CPEO] or other phenotypes of MM). [ng.neurology.org]

Workup

The diagnostic workup requires a complex approach that includes routine and special laboratory tests. [rarediseases.org]

Treatment

There is a major unmet medical need for new and effective treatment options for mitochondrial myopathies since there is no specific treatment for these serious diseases. [neurovive.com]

Treatment Although there is no specific treatment for any of the mitochondrial myopathies, physical therapy may extend the range of movement of muscles and improve dexterity. [ninds.nih.gov]

To better elucidate the treatment landscape for PMM, NeurologyLive spoke with Bruce H. [neurologylive.com]

Prognosis

Prognosis The prognosis for patients with mitochondrial myopathies varies greatly, depending largely on the type of disease and the degree of involvement of various organs. [ninds.nih.gov]

Prognosis The prognosis for patients with mitochondrial myopathies varies greatly, depending largely on the type of disease and the degree of involvement of various organs. These disorders cause progressive weakness and can lead to death. [brainfacts.org]

The prognosis for these disorders ranges in severity from progressive weakness to death. CONTINUE SCROLLING OR CLICK HERE FOR RELATED ARTICLE SLIDESHOW Heart Disease: Causes of a Heart Attack See Slideshow [medicinenet.com]

Etiology

Other etiologies such as deconditioning, obesity, malignancy, anemia, and sleep apnea are described less frequently ( 1-4 ), and often the cause remains elusive after an aggressive evaluation ( 3 ). [atsjournals.org]

Research over the years has identified many underlying biological abnormalities, mitochondrial dysfunction among them, but the etiology remains uncertain. 2 No intervention has been proven effective in restoring the ability to work. 3 Primary mitochondrial [journals.sagepub.com]

Epidemiology

International The first assessment of the epidemiology of mitochondrial disorders found a prevalence of more than 10.2 per 100,000 for the m.3243A → G mutation in the adult Finnish population. [emedicine.medscape.com]

Chinnery PF, Johnson MA, Wardell TM, Singh-Kler R, Hayes C, Brown DT, Taylor RW, Bindoff LA, Turnbull DM: The epidemiology of pathogenic mitochondrial DNA mutations. Ann Neurol. 2000, 48: 188-193. 10.1002/1531-8249(200008)48:2 3.0.CO;2-P. 11. [jmedicalcasereports.biomedcentral.com]

Within the mitochondrial diseases, PMM are very common but real epidemiological studies are not available yet. This is also because PMM often go misdiagnosed or undiagnosed so determining their true frequency in the general population is difficult. [rarediseases.org]

ENMC workshop on “Genetic Epidemiology and Clinical Trial Readiness in Encephalomyopathy of Leigh Syndrome”, 16 Octobre et 20 Décembre 2020, 9 Juillet 2021. Agnès Rötig. [maladiesrares-necker.aphp.fr]

Pathophysiology

[…] inflammatory myopathies, including polymyositis, dermatomyositis, and inclusion body myositis, 2 3 and mitochondrial DNA abnormalities were recently described in patients with inclusion body myositis. 3 However, these changes are considered secondary and their pathophysiological [jnnp.bmj.com]

This makes sense from a pathophysiological point of view, because small fiber neuropathy affects small somatic fibers and autonomic fibers, being able to give sensory and autonomic symptoms. [journals.sagepub.com]

Post operative CNS dysfunction is likely in MM and pathophysiology is directly attributable to the patient’s primary pathology of dysfunctional mitochondria. [mhaus.org]

A tool for diagnostic purposes and pathophysiological insights in muscle diseases. Reumatismo. 2004; 56 9-14 18 Möller H E, Kurlemann G, Pützler M. et al. Magnetic resonance spectroscopy in patients with MELAS. [thieme-connect.com]

Wallace DL, Zheng X, Lott MT - Familial mitochondrial encephalomyopathy (MERRF): genetic, pathophysiological, and biochemical characterization of a mitochondrial DNA disease. Cell 55:601, 1988. [ Links ] 51. [scielo.br]

Prevention

Moreover, strict anti-epileptic therapy and treatment or prevention of stroke-like episodes are very important to prevent complications. [ncbi.nlm.nih.gov]

The goal is to develop a treatment that protects the mitochondria in the muscles from disturbed calcium handling and subsequent muscular dystrophy, thus preventing the muscle weakness associated with these diseases. [neurovive.com]

Prevention There are no current guidelines to prevent mitochondrial myopathies. If you have a family history of the disorder, you can talk to a genetic counselor when deciding whether to have children. References DiMauro S. [lahey.org]

Research is ongoing to develop a way to prevent the transmission of mitochondrial DNA mutations to future children. [mda.org.au]

The energetics from mitochondria maintain healthy physiology and prevent disease. This mitochondria-targeted candidate is being developed for both rare and common diseases. [stealthbt.com]

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