Symptoma

Mitochondrial Neurogastrointestinal Encephalomyopathy

TYMP-Related MNGIE

The disease presents in childhood, but often goes unnoticed for decades. [en.wikipedia.org]

In a 38-year-old male patient diagnosed with mitochondrial neurogastrointestinal encephalomyopathy an abnormally high duodenal contraction frequency of 20 per minute was found to be present. [ncbi.nlm.nih.gov]

  • Whipple Disease

    disease or other gastrointestinal disorder. [brain.oxfordjournals.org]

  • Sepsis

    The average age of death is 35 years (range 15–54 years) and identified causes included: pneumonia due to aspiration (eight patients); peritonitis due to intestinal rupture (two patients); suicide (two patients); electrolyte imbalance (two patients); sepsis [brain.oxfordjournals.org]

  • Nausea

    MNGIE is clinically characterized by ophthalmoparesis, peripheral neuropathy, leukoencephalopathy, gastrointestinal symptoms (recurrent nausea, vomiting, or diarrhea) with intestinal dysmotility, and histologically abnormal mitochondria in muscle. [ncbi.nlm.nih.gov]

    Additionally, gastrointestinal symptoms such as borborygmi, early satiety, diarrhea, constipation, gastroparesis, nausea, vomiting, weight loss, and diverticulitis may be present in MNGIE patients. [en.wikipedia.org]

    The main symptoms of Mitochondrial Neurogastrointestinal Encephalopathy Disease are progressive gastrointestinal symptoms such as nausea, inability to swallow, reflux, vomiting, abdominal pain and diarrhea. [thinkgenetic.com]

    These symptoms included: diarrhoea (11/36); abdominal pain (8/36); nausea/vomiting (6/36); abdominal cramps (6/36); weight loss (4/36); borborygmi (3/36); wasting/failure to thrive/thin (2/36); intestinal pseudo-obstruction (2/36); bloating (1/36); and [brain.oxfordjournals.org]

  • Abdominal Pain

    Back to: « Mitochondrial DNA depletion syndrome Symptoms of Mitochondrial DNA depletion syndrome type 1 Clinical features : Imported from Human Phenotype Ontology (HPO) Abnormality of the abdomen Abdominal pain Constipation Gastrointestinal dysmotility [familydiagnosis.com]

    The main symptoms of Mitochondrial Neurogastrointestinal Encephalopathy Disease are progressive gastrointestinal symptoms such as nausea, inability to swallow, reflux, vomiting, abdominal pain and diarrhea. [thinkgenetic.com]

    Added to this are gastroparesis, constipation, vomiting, and intermittent diarrhea with abdominal pain. Many individuals develop diverticulosis and diverticulitis that may lead to intestinal perforations. [disorders.eyes.arizona.edu]

    The symptoms that affected patients present vary, but the most common presenting symptoms are gastrointestinal issues such as nausea, vomiting, abdominal pain, and diarrhea, and neurologic or ocular symptoms such as hearing loss, weakness, and peripheral [en.wikipedia.org]

    These symptoms included: diarrhoea (11/36); abdominal pain (8/36); nausea/vomiting (6/36); abdominal cramps (6/36); weight loss (4/36); borborygmi (3/36); wasting/failure to thrive/thin (2/36); intestinal pseudo-obstruction (2/36); bloating (1/36); and [brain.oxfordjournals.org]

  • Abdominal Cramps

    The post-transplant clinical follow-up showed improvement in gastrointestinal dysmotility, abdominal cramps and diarrhea. Neurological assessment remained unchanged. [ncbi.nlm.nih.gov]

    These symptoms included: diarrhoea (11/36); abdominal pain (8/36); nausea/vomiting (6/36); abdominal cramps (6/36); weight loss (4/36); borborygmi (3/36); wasting/failure to thrive/thin (2/36); intestinal pseudo-obstruction (2/36); bloating (1/36); and [brain.oxfordjournals.org]

  • Borborygmi

    Additionally, gastrointestinal symptoms such as borborygmi, early satiety, diarrhea, constipation, gastroparesis, nausea, vomiting, weight loss, and diverticulitis may be present in MNGIE patients. [en.wikipedia.org]

    These symptoms included: diarrhoea (11/36); abdominal pain (8/36); nausea/vomiting (6/36); abdominal cramps (6/36); weight loss (4/36); borborygmi (3/36); wasting/failure to thrive/thin (2/36); intestinal pseudo-obstruction (2/36); bloating (1/36); and [brain.oxfordjournals.org]

  • Abdominal Distension

    Case 2: This 6½-month-old boy born to a non-consanguineous couple presented with persistent jaundice and abdominal distension since four months of age. [indianpediatrics.net]

  • Kinky Hair

    Danks DM, Cartwright E, Stevens BJ, Townley RRW (1973) Menkes' kinky hair disease: further definition of the defect in copper transport. Science 179:1140–1142 Google Scholar 6. [doi.org]

  • Leg Cramp

    In our cohort, 9/63 (14%) patients presented with: peripheral neuropathy manifesting as numbness or foot drop (5/9); limb weakness and paraesthesia (1/9); leg cramps (1/9); tripping (1/9); or hearing loss (1/9). [brain.oxfordjournals.org]

  • Hearing Impairment

    The disease can cause the slowing down of thoughts and a reduction in physical movement, hearing impairment and seizures. [thesun.co.uk]

    Hearing impairment associated to severe encephalomyopathy has been only reported in one family with MDS caused by SUCLA2 mutations ( 14 ). [nature.com]

    impairment and ophthalmoplegia [ 6 ]. [ijponline.biomedcentral.com]

  • Psychiatric Symptoms

    2000 ), an increasing number of patients have been noted to have mild neurological symptoms such as cognitive impairment, dementia, seizure, headache or other psychiatric symptoms. [brain.oxfordjournals.org]

    symptoms, eye movement disorders, involuntary movements, peripheral neuropathy. [umdf.org]

  • Amenorrhea

    Malnutrition caused anaemia in four patients and amenorrhea in two patients. Other sporadic findings included: pigmentary retinopathy (three patients); dry mouth/eyes (three patients); psoriasis (one patient); and coarse bronze skin (one patient). [brain.oxfordjournals.org]

His weight was 6 kg and height was 60 cm (both His metabolic workup, including screening for Galactosemia, Tyrosinemia type 1, amino acids, organic acids and fatty acid oxidation defects, was normal. Plasma lactate was elevated on several occasions. [indianpediatrics.net]

  • Amylase Increased

    The clinical course was complicated by an endocrine or exocrine pancreatic insufficiency in nine patients: diabetes (four patients); amylase increase (two patients); glucose intolerance (one patient); or exocrine insufficiency (two patients). [brain.oxfordjournals.org]

  • White Matter Lesions

    BAEPs may be useful in the neurophysiological evaluation of central white matter lesions in MNGIE. Similar neurophysiological findings have been reported in other myelin disorders in the central nervous system. [ncbi.nlm.nih.gov]

    The white matter lesions appear hyperintense on T 2 -weighted or fluid-attenuated inversion recovery images and may initially be patchy, but eventually become diffuse and confluent. [brain.oxfordjournals.org]

Management and treatment Management is mainly symptomatic, involving treatment of the chronic intestinal pseudo-obstruction. Thymidine and deoxyguanosine clearance appears to be an efficient approach. [orpha.net]

Because of the intense rarity of the condition, there are currently no widely available treatments for patients like Charlie. [frontlinegenomics.com]

Acute medical events such as infections often provoked worsening of symptoms, suggesting that careful monitoring and early treatment of intercurrent illnesses may be beneficial. [ncbi.nlm.nih.gov]

Very few people who develop the condition in infancy survive to their teenage years, and there is currently no known treatment for it. [metro.co.uk]

Prognosis The prognosis is unfavorable due to the severity of the digestive involvement with infections and the need for permanent parenteral nutrition. The documents contained in this web site are presented for information purposes only. [orpha.net]

These are severe disorders with poor prognosis in the majority of cases. So far, no therapy or cure exists to help patients, although nutritional interventions or supplementation can be beneficial for some children. [ibtimes.co.uk]

Conversely, the absence of eye abnormalities may portend a better prognosis and a possible beneficial effect of liver transplantation. [journals.lww.com]

The prognosis for MELAS is poor. Typically, the age of death is between 10 to 35 years, although some patients may live longer. [umdf.org]

PROGNOSIS Prognosis depends upon which disorder, which symptoms and the severity of those symptoms. Some of the conditions we thought were uniformly progressive and fatal are not (Leigh syndrome, for example). [childneurologyfoundation.org]

Etiology MNGIE syndrome is inherited in an autosomal recessive manner and is caused by mutations in the TYMP gene (22q13.32-qter), encoding a protein involved in thymidine phosphorylation. [orpha.net]

Other genes may also be involved in the etiology of myopathic MDS. [pediatricneurologybriefs.com]

Liver transplant was not performed in view of mitochondrial etiology and neurological involvement (as evident on neuroimaging). [indianpediatrics.net]

Table 1 summarizes the main clinical manifestations and molecular etiologies associated with these different forms. [ijponline.biomedcentral.com]

Houston Recruiting NCT02023866 Open-Label, Dose-Escalating Study to Assess Safety, Tolerability, Efficacy, PK and PD of RP103 in Children With Inherited Mitochondrial Disease Genetically diagnosed mitochondrial disease Raptor Pharma Completed NCT02003170 Etiology [mitoaction.org]

Summary Epidemiology So far, just under 100 sporadic and familial cases have been reported. Clinical description The first clinical manifestations generally appear between the ages of 10 and 40 (most often before 20 years of age). [orpha.net]

Results Epidemiology A cohort of 102 patients (50 females) with an average age of 32.4 years (range 11–59 years) was collected between 1988 and 2011. [brain.oxfordjournals.org]

The incidence is unknown, although the epidemiological studies of the MELAS-3243 mtDNA mutation have estimated the prevalence to be 1-16/100,000 in the adult population. There is no cure or specific treatment for MELAS. [umdf.org]

TP deficiency alone is unlikely to explain all clinical signs, and other factors, including the possible development of anti-TP antibodies, which may play a role in the pathophysiology. [ncbi.nlm.nih.gov]

[…] article is freely available re-usable Review Genes and Pathways Involved in Adult Onset Disorders Featuring Muscle Mitochondrial DNA Instability Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Centre, Department of Pathophysiology [mdpi.com]

We used formulas enriched with medium-chain triglyceride content and fractional meals with enteral nutrition at night for adequate nutrition to prevent hypoglycemia. He continued to deteriorate rapidly, leading to death at 4 months of age. [journals.lww.com]

: Mitochondrial DNA depletion can be prevented by dGMP and dAMP supplementation in a resting culture of deoxyguanosine kinase-deficient fibroblasts. Hum. Molec. Genet. 12: 1839-1845, 2003. PubMed ID : 12874104 Tadiboyina, V. [humpath.com]

Our report has thus direct important implications for clinical practice: it prevents a burdensome, long-term invasive, but finally probably ineffective procedure in MNGIE patients. [ncbi.nlm.nih.gov]

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. [azkrmc.com]

Can we prevent Mitochondrial Disease? Yes. [mitochondrialdisease.nhs.uk]

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