U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Combined oxidative phosphorylation deficiency 37(COXPD37)

MedGen UID:
1675208
Concept ID:
C5193031
Disease or Syndrome
Synonym: COXPD37
 
Gene (location): MICOS13 (19p13.3)
 
Monarch Initiative: MONDO:0032679
OMIM®: 618329

Definition

Combined oxidative phosphorylation deficiency-37 is an autosomal recessive multisystem disorder apparent at birth or in the first months of life. Affected individuals have hypotonia, failure to thrive, and neurodegeneration with loss of developmental milestones, as well as liver dysfunction. Some patients may have hypertrophic cardiomyopathy, loss of vision and hearing, and/or seizures. Mitochondrial respiratory dysfunction is apparent in liver and skeletal muscle tissue. Most patients die in childhood (summary by Zeharia et al., 2016). For a discussion of genetic heterogeneity of combined oxidative phosphorylation deficiency, see COXPD1 (609060). [from OMIM]

Clinical features

From HPO
3-Methylglutaconic aciduria
MedGen UID:
777186
Concept ID:
C3696376
Disease or Syndrome
An increased amount of 3-methylglutaconic acid in the urine.
Hypertrophic cardiomyopathy
MedGen UID:
2881
Concept ID:
C0007194
Disease or Syndrome
Hypertrophic cardiomyopathy (HCM) is defined by the presence of increased ventricular wall thickness or mass in the absence of loading conditions (hypertension, valve disease) sufficient to cause the observed abnormality.
Failure to thrive
MedGen UID:
746019
Concept ID:
C2315100
Disease or Syndrome
Failure to thrive (FTT) refers to a child whose physical growth is substantially below the norm.
Feeding difficulties
MedGen UID:
65429
Concept ID:
C0232466
Finding
Impaired ability to eat related to problems gathering food and getting ready to suck, chew, or swallow it.
Decreased liver function
MedGen UID:
65430
Concept ID:
C0232744
Finding
Reduced ability of the liver to perform its functions.
Bile duct proliferation
MedGen UID:
120603
Concept ID:
C0267818
Disease or Syndrome
Proliferative changes of the bile ducts.
Macrovesicular hepatic steatosis
MedGen UID:
373290
Concept ID:
C1837256
Finding
A form of hepatic steatosis characterized by the presence of large, lipid-laden vesicles in the affected hepatocytes.
Sensorineural hearing loss disorder
MedGen UID:
9164
Concept ID:
C0018784
Disease or Syndrome
A type of hearing impairment in one or both ears related to an abnormal functionality of the cochlear nerve.
Spasticity
MedGen UID:
7753
Concept ID:
C0026838
Sign or Symptom
A motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes with increased muscle tone, exaggerated (hyperexcitable) tendon reflexes.
Hyperreflexia
MedGen UID:
57738
Concept ID:
C0151889
Finding
Hyperreflexia is the presence of hyperactive stretch reflexes of the muscles.
Cerebellar hypoplasia
MedGen UID:
120578
Concept ID:
C0266470
Congenital Abnormality
Cerebellar hypoplasia is a descriptive term implying a cerebellum with a reduced volume, but a normal shape and is stable over time.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Cerebellar atrophy
MedGen UID:
196624
Concept ID:
C0740279
Disease or Syndrome
Cerebellar atrophy is defined as a cerebellum with initially normal structures, in a posterior fossa with normal size, which displays enlarged fissures (interfolial spaces) in comparison to the foliae secondary to loss of tissue. Cerebellar atrophy implies irreversible loss of tissue and result from an ongoing progressive disease until a final stage is reached or a single injury, e.g. an intoxication or infectious event.
Persistent head lag
MedGen UID:
256151
Concept ID:
C1141883
Finding
The Premie-Neuro and the Dubowitz Neurological Examination score head lag in the same manner. Scoring for both is as follows
Reduced eye contact
MedGen UID:
303190
Concept ID:
C1445953
Finding
A reduced frequency or duration of eye contact.
Progressive neurologic deterioration
MedGen UID:
381506
Concept ID:
C1854838
Finding
Myoclonic seizure
MedGen UID:
1385980
Concept ID:
C4317123
Sign or Symptom
A myoclonic seizure is a type of motor seizure characterized by sudden, brief (<100 ms) involuntary single or multiple contraction of muscles or muscle groups of variable topography (axial, proximal limb, distal). Myoclonus is less regularly repetitive and less sustained than is clonus.
Prolonged prothrombin time
MedGen UID:
208879
Concept ID:
C0853225
Finding
Increased time to coagulation in the prothrombin time test, which is a measure of the extrinsic pathway of coagulation. The results of the prothrombin time test are often expressed in terms of the International normalized ratio (INR), which is calculated as a ratio of the patient's prothrombin time (PT) to a control PT standardized for the potency of the thromboplastin reagent developed by the World Health Organization (WHO) using the formula
Hypotonia
MedGen UID:
10133
Concept ID:
C0026827
Finding
Hypotonia is an abnormally low muscle tone (the amount of tension or resistance to movement in a muscle). Even when relaxed, muscles have a continuous and passive partial contraction which provides some resistance to passive stretching. Hypotonia thus manifests as diminished resistance to passive stretching. Hypotonia is not the same as muscle weakness, although the two conditions can co-exist.
Secondary microcephaly
MedGen UID:
608952
Concept ID:
C0431352
Finding
Head circumference which falls below 2 standard deviations below the mean for age and gender because of insufficient head growth after birth.
Poor head control
MedGen UID:
322809
Concept ID:
C1836038
Finding
Difficulty to maintain correct position of the head while standing or sitting.
Axial hypotonia
MedGen UID:
342959
Concept ID:
C1853743
Finding
Muscular hypotonia (abnormally low muscle tone) affecting the musculature of the trunk.
Generalized hypotonia
MedGen UID:
346841
Concept ID:
C1858120
Finding
Generalized muscular hypotonia (abnormally low muscle tone).
Respiratory insufficiency
MedGen UID:
11197
Concept ID:
C0035229
Pathologic Function
Impairment of gas exchange within the lungs secondary to a disease process, neoplasm, or trauma, possibly resulting in hypoxia, hypercarbia, or both, but not requiring intubation or mechanical ventilation. Patients are normally managed with pharmaceutical therapy, supplemental oxygen, or both.
Respiratory failure
MedGen UID:
257837
Concept ID:
C1145670
Disease or Syndrome
A severe form of respiratory insufficiency characterized by inadequate gas exchange such that the levels of oxygen or carbon dioxide cannot be maintained within normal limits.
Lactic acidosis
MedGen UID:
1717
Concept ID:
C0001125
Disease or Syndrome
An abnormal buildup of lactic acid in the body, leading to acidification of the blood and other bodily fluids.
Hypoglycemia
MedGen UID:
6979
Concept ID:
C0020615
Disease or Syndrome
A decreased concentration of glucose in the blood.
Hypothermia
MedGen UID:
5720
Concept ID:
C0020672
Finding
Reduced body temperature due to failed thermoregulation.
Hypoalbuminemia
MedGen UID:
68694
Concept ID:
C0239981
Finding
Reduction in the concentration of albumin in the blood.
Hyper-beta-alaninemia
MedGen UID:
75702
Concept ID:
C0268630
Disease or Syndrome
An increased concentration of alanine in the blood.
Increased circulating lactate concentration
MedGen UID:
332209
Concept ID:
C1836440
Finding
Abnormally increased level of blood lactate (2-hydroxypropanoic acid). Lactate is produced from pyruvate by lactate dehydrogenase during normal metabolism. The terms lactate and lactic acid are often used interchangeably but lactate (the component measured in blood) is strictly a weak base whereas lactic acid is the corresponding acid. Lactic acidosis is often used clinically to describe elevated lactate but should be reserved for cases where there is a corresponding acidosis (pH below 7.35).
Elevated circulating hepatic transaminase concentration
MedGen UID:
338525
Concept ID:
C1848701
Finding
Elevations of the levels of SGOT and SGPT in the serum. SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamic pyruvic transaminase) are transaminases primarily found in the liver and heart and are released into the bloodstream as the result of liver or heart damage. SGOT and SGPT are used clinically mainly as markers of liver damage.
Elevated gamma-glutamyltransferase level
MedGen UID:
1370086
Concept ID:
C4476869
Finding
Increased level of the enzyme gamma-glutamyltransferase (GGT). GGT is mainly present in kidney, liver, and pancreatic cells, but small amounts are present in other tissues.
Optic atrophy
MedGen UID:
18180
Concept ID:
C0029124
Disease or Syndrome
Atrophy of the optic nerve. Optic atrophy results from the death of the retinal ganglion cell axons that comprise the optic nerve and manifesting as a pale optic nerve on fundoscopy.
Visual impairment
MedGen UID:
777085
Concept ID:
C3665347
Finding
Visual impairment (or vision impairment) is vision loss (of a person) to such a degree as to qualify as an additional support need through a significant limitation of visual capability resulting from either disease, trauma, or congenital or degenerative conditions that cannot be corrected by conventional means, such as refractive correction, medication, or surgery.
Chorioretinal hyperpigmentation
MedGen UID:
868091
Concept ID:
C4022482
Finding

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  

Professional guidelines

PubMed

Peretz RH, Ah Mew N, Vernon HJ, Ganetzky RD
Mol Genet Metab 2021 Sep-Oct;134(1-2):37-42. Epub 2021 Jun 24 doi: 10.1016/j.ymgme.2021.06.007. PMID: 34176718Free PMC Article
Berman MH, Nichols TW
Photobiomodul Photomed Laser Surg 2019 Oct;37(10):623-634. doi: 10.1089/photob.2019.4685. PMID: 31647776
Ferlazzo E, Trenite DK, Haan GJ, Felix Nitschke F, Ahonen S, Gasparini S, Minassian BA
Curr Pharm Des 2017;23(37):5662-5666. doi: 10.2174/1381612823666170809114654. PMID: 28799509Free PMC Article

Recent clinical studies

Etiology

Payne T, Burgess T, Bradley S, Roscoe S, Sassani M, Dunning MJ, Hernandez D, Scholz S, McNeill A, Taylor R, Su L, Wilkinson I, Jenkins T, Mortiboys H, Bandmann O
Brain 2024 Jan 4;147(1):267-280. doi: 10.1093/brain/awad364. PMID: 38059801Free PMC Article
Aleksic D, Jankovic MG, Todorovic S, Kovacevic M, Borkovic M
Turk J Pediatr 2023;65(6):1018-1024. doi: 10.24953/turkjped.2022.1082. PMID: 38204316
Baide-Mairena H, Marti-Sánchez L, Marcé-Grau A, Cazurro-Gutiérrez A, Sanchez-Montanez A, Delgado I, Moreno-Galdó A, Macaya-Ruiz A, García-Arumí E, Pérez-Dueñas B; Childhood Basal Ganglia Disease Group
Dev Med Child Neurol 2022 Jun;64(6):743-752. Epub 2022 Jan 5 doi: 10.1111/dmcn.15125. PMID: 34988976
Tournadre A
Joint Bone Spine 2020 Jan;87(1):37-42. Epub 2019 Feb 6 doi: 10.1016/j.jbspin.2019.01.018. PMID: 30735805
Ferlazzo E, Trenite DK, Haan GJ, Felix Nitschke F, Ahonen S, Gasparini S, Minassian BA
Curr Pharm Des 2017;23(37):5662-5666. doi: 10.2174/1381612823666170809114654. PMID: 28799509Free PMC Article

Diagnosis

Aleksic D, Jankovic MG, Todorovic S, Kovacevic M, Borkovic M
Turk J Pediatr 2023;65(6):1018-1024. doi: 10.24953/turkjped.2022.1082. PMID: 38204316
Baide-Mairena H, Marti-Sánchez L, Marcé-Grau A, Cazurro-Gutiérrez A, Sanchez-Montanez A, Delgado I, Moreno-Galdó A, Macaya-Ruiz A, García-Arumí E, Pérez-Dueñas B; Childhood Basal Ganglia Disease Group
Dev Med Child Neurol 2022 Jun;64(6):743-752. Epub 2022 Jan 5 doi: 10.1111/dmcn.15125. PMID: 34988976
Tournadre A
Joint Bone Spine 2020 Jan;87(1):37-42. Epub 2019 Feb 6 doi: 10.1016/j.jbspin.2019.01.018. PMID: 30735805
Saneto RP
Adv Genet 2017;98:63-116. Epub 2017 Sep 1 doi: 10.1016/bs.adgen.2017.06.002. PMID: 28942795
Rahman S
Dev Med Child Neurol 2012 May;54(5):397-406. Epub 2012 Jan 28 doi: 10.1111/j.1469-8749.2011.04214.x. PMID: 22283595

Therapy

Sibiya T, Ghazi T, Chuturgoon A
Nutrients 2022 Jul 27;14(15) doi: 10.3390/nu14153076. PMID: 35893930Free PMC Article
Tournadre A
Joint Bone Spine 2020 Jan;87(1):37-42. Epub 2019 Feb 6 doi: 10.1016/j.jbspin.2019.01.018. PMID: 30735805
Berman MH, Nichols TW
Photobiomodul Photomed Laser Surg 2019 Oct;37(10):623-634. doi: 10.1089/photob.2019.4685. PMID: 31647776
Thakur S, Daley B, Klubo-Gwiezdzinska J
J Mol Endocrinol 2019 Aug;63(2):R17-R35. doi: 10.1530/JME-19-0083. PMID: 31307011Free PMC Article
Ferlazzo E, Trenite DK, Haan GJ, Felix Nitschke F, Ahonen S, Gasparini S, Minassian BA
Curr Pharm Des 2017;23(37):5662-5666. doi: 10.2174/1381612823666170809114654. PMID: 28799509Free PMC Article

Prognosis

Herman I, Lopez MA, Marafi D, Pehlivan D, Calame DG, Abid F, Lotze TE
Muscle Nerve 2021 Mar;63(3):304-310. Epub 2020 Nov 13 doi: 10.1002/mus.27112. PMID: 33146414
Berman MH, Nichols TW
Photobiomodul Photomed Laser Surg 2019 Oct;37(10):623-634. doi: 10.1089/photob.2019.4685. PMID: 31647776
Keuper M, Sachs S, Walheim E, Berti L, Raedle B, Tews D, Fischer-Posovszky P, Wabitsch M, Hrabě de Angelis M, Kastenmüller G, Tschöp MH, Jastroch M, Staiger H, Hofmann SM
Mol Metab 2017 Oct;6(10):1226-1239. Epub 2017 Jul 19 doi: 10.1016/j.molmet.2017.07.008. PMID: 29031722Free PMC Article
Mühlhausen C, Salomons GS, Lukacs Z, Struys EA, van der Knaap MS, Ullrich K, Santer R
J Inherit Metab Dis 2014 Sep;37(5):775-81. Epub 2014 Apr 1 doi: 10.1007/s10545-014-9702-y. PMID: 24687295
Rahman S
Dev Med Child Neurol 2012 May;54(5):397-406. Epub 2012 Jan 28 doi: 10.1111/j.1469-8749.2011.04214.x. PMID: 22283595

Clinical prediction guides

Baide-Mairena H, Marti-Sánchez L, Marcé-Grau A, Cazurro-Gutiérrez A, Sanchez-Montanez A, Delgado I, Moreno-Galdó A, Macaya-Ruiz A, García-Arumí E, Pérez-Dueñas B; Childhood Basal Ganglia Disease Group
Dev Med Child Neurol 2022 Jun;64(6):743-752. Epub 2022 Jan 5 doi: 10.1111/dmcn.15125. PMID: 34988976
Ferlazzo E, Trenite DK, Haan GJ, Felix Nitschke F, Ahonen S, Gasparini S, Minassian BA
Curr Pharm Des 2017;23(37):5662-5666. doi: 10.2174/1381612823666170809114654. PMID: 28799509Free PMC Article
Belloum Y, Rannou-Bekono F, Favier FB
Oncol Rep 2017 May;37(5):2543-2552. Epub 2017 Mar 31 doi: 10.3892/or.2017.5542. PMID: 28393216
Hawash MB, Betson M, Al-Jubury A, Ketzis J, LeeWillingham A, Bertelsen MF, Cooper PJ, Littlewood DT, Zhu XQ, Nejsum P
Parasit Vectors 2016 Jan 22;9:37. doi: 10.1186/s13071-016-1325-8. PMID: 26800683Free PMC Article
Mühlhausen C, Salomons GS, Lukacs Z, Struys EA, van der Knaap MS, Ullrich K, Santer R
J Inherit Metab Dis 2014 Sep;37(5):775-81. Epub 2014 Apr 1 doi: 10.1007/s10545-014-9702-y. PMID: 24687295

Recent systematic reviews

Noorda G, Hermans-Peters M, Smeitink J, van Achterberg T, Kemps H, Goverde W, Schoonhoven L
J Inherit Metab Dis 2007 Jun;30(3):333-40. Epub 2007 May 11 doi: 10.1007/s10545-007-0426-0. PMID: 17508266Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...