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Neonatal encephalomyopathy-cardiomyopathy-respiratory distress syndrome(COQ10D7)

MedGen UID:
1799985
Concept ID:
C5568562
Disease or Syndrome
Synonym: Coenzyme Q10 deficiency, primary, 7
SNOMED CT: Neonatal encephalomyopathy, cardiomyopathy, respiratory distress syndrome (1186718008); Coenzyme Q4-related neonatal encephalomyopathy (1186718008); COQ4-related neonatal encephalomyopathy (1186718008)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): COQ4 (9q34.11)
 
Monarch Initiative: MONDO:0014562
OMIM®: 616276
Orphanet: ORPHA457185

Authors:
Leonardo Salviati  |  Eva Trevisson  |  Caterina Agosto, et. al.   view full author information

Additional descriptions

From GeneReviews Overview
Primary coenzyme Q10 (CoQ10) deficiency is usually associated with multisystem involvement, including neurologic manifestations such as fatal neonatal encephalopathy with hypotonia; a late-onset slowly progressive multiple-system atrophy-like phenotype (neurodegeneration with autonomic failure and various combinations of parkinsonism and cerebellar ataxia, and pyramidal dysfunction); and dystonia, spasticity, seizures, and intellectual disability. Steroid-resistant nephrotic syndrome (SRNS), the hallmark renal manifestation, is often the initial manifestation either as isolated renal involvement that progresses to end-stage renal disease (ESRD), or associated with encephalopathy (seizures, stroke-like episodes, severe neurologic impairment) resulting in early death. Hypertrophic cardiomyopathy (HCM), retinopathy or optic atrophy, and sensorineural hearing loss can also be seen.
From OMIM
Primary coenzyme Q10 deficiency-7 (COQ10D7) is an autosomal recessive disorder resulting from mitochondrial dysfunction. Most patients have onset of severe cardiac or neurologic symptoms soon after birth, usually resulting in death. Rare patients may have later onset with a more protracted course. Tissue samples from affected individuals show decreased levels of coenzyme Q10 (CoQ10) (summary by Brea-Calvo et al., 2015). For a general phenotypic description and a discussion of genetic heterogeneity of primary coenzyme Q10 deficiency, see COQ10D1 (607426).  http://www.omim.org/entry/616276

Clinical features

From HPO
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.
Patent ductus arteriosus
MedGen UID:
4415
Concept ID:
C0013274
Congenital Abnormality
In utero, the ductus arteriosus (DA) serves to divert ventricular output away from the lungs and toward the placenta by connecting the main pulmonary artery to the descending aorta. A patent ductus arteriosus (PDA) in the first 3 days of life is a physiologic shunt in healthy term and preterm newborn infants, and normally is substantially closed within about 24 hours after bith and completely closed after about three weeks. Failure of physiologcal closure is referred to a persistent or patent ductus arteriosus (PDA). Depending on the degree of left-to-right shunting, PDA can have clinical consequences.
Ventricular septal defect
MedGen UID:
42366
Concept ID:
C0018818
Congenital Abnormality
A hole between the two bottom chambers (ventricles) of the heart. The defect is centered around the most superior aspect of the ventricular septum.
Hypoplastic left heart
MedGen UID:
57746
Concept ID:
C0152101
Disease or Syndrome
Critical congenital heart disease (CCHD) is a term that refers to a group of serious heart defects that are present from birth. These abnormalities result from problems with the formation of one or more parts of the heart during the early stages of embryonic development. CCHD prevents the heart from pumping blood effectively or reduces the amount of oxygen in the blood. As a result, organs and tissues throughout the body do not receive enough oxygen, which can lead to organ damage and life-threatening complications. Individuals with CCHD usually require surgery soon after birth.\n\nAlthough babies with CCHD may appear healthy for the first few hours or days of life, signs and symptoms soon become apparent. These can include an abnormal heart sound during a heartbeat (heart murmur), rapid breathing (tachypnea), low blood pressure (hypotension), low levels of oxygen in the blood (hypoxemia), and a blue or purple tint to the skin caused by a shortage of oxygen (cyanosis). If untreated, CCHD can lead to shock, coma, and death. However, most people with CCHD now survive past infancy due to improvements in early detection, diagnosis, and treatment.\n\nSome people with treated CCHD have few related health problems later in life. However, long-term effects of CCHD can include delayed development and reduced stamina during exercise. Adults with these heart defects have an increased risk of abnormal heart rhythms, heart failure, sudden cardiac arrest, stroke, and premature death.\n\nEach of the heart defects associated with CCHD affects the flow of blood into, out of, or through the heart. Some of the heart defects involve structures within the heart itself, such as the two lower chambers of the heart (the ventricles) or the valves that control blood flow through the heart. Others affect the structure of the large blood vessels leading into and out of the heart (including the aorta and pulmonary artery). Still others involve a combination of these structural abnormalities.\n\nPeople with CCHD have one or more specific heart defects. The heart defects classified as CCHD include coarctation of the aorta, double-outlet right ventricle, D-transposition of the great arteries, Ebstein anomaly, hypoplastic left heart syndrome, interrupted aortic arch, pulmonary atresia with intact septum, single ventricle, total anomalous pulmonary venous connection, tetralogy of Fallot, tricuspid atresia, and truncus arteriosus.
Bradycardia
MedGen UID:
140901
Concept ID:
C0428977
Finding
A slower than normal heart rate (in adults, slower than 60 beats per minute).
Fetal growth restriction
MedGen UID:
4693
Concept ID:
C0015934
Pathologic Function
An abnormal restriction of fetal growth with fetal weight below the tenth percentile for gestational age.
Dysphagia
MedGen UID:
41440
Concept ID:
C0011168
Disease or Syndrome
Difficulty in swallowing.
Intellectual disability, moderate
MedGen UID:
7680
Concept ID:
C0026351
Mental or Behavioral Dysfunction
Moderate mental retardation is defined as an intelligence quotient (IQ) in the range of 35-49.
Seizure
MedGen UID:
20693
Concept ID:
C0036572
Sign or Symptom
A seizure is an intermittent abnormality of nervous system physiology characterised by a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
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.
Epileptic encephalopathy
MedGen UID:
452596
Concept ID:
C0543888
Disease or Syndrome
A condition in which epileptiform abnormalities are believed to contribute to the progressive disturbance in cerebral function. Epileptic encephalaopathy is characterized by (1) electrographic EEG paroxysmal activity that is often aggressive, (2) seizures that are usually multiform and intractable, (3) cognitive, behavioral and neurological deficits that may be relentless, and (4) sometimes early death.
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.
Scoliosis
MedGen UID:
11348
Concept ID:
C0036439
Disease or Syndrome
The presence of an abnormal lateral curvature of the spine.
Muscle weakness
MedGen UID:
57735
Concept ID:
C0151786
Finding
Reduced strength of muscles.
Neonatal hypotonia
MedGen UID:
412209
Concept ID:
C2267233
Disease or Syndrome
Muscular hypotonia (abnormally low muscle tone) manifesting in the neonatal period.
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.
Increased serum lactate
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).
Epicanthus
MedGen UID:
151862
Concept ID:
C0678230
Congenital Abnormality
Epicanthus is a condition in which a fold of skin stretches from the upper to the lower eyelid, partially covering the inner canthus. Usher (1935) noted that epicanthus is a normal finding in the fetus of all races. Epicanthus also occurs in association with hereditary ptosis (110100).
Coarse facial features
MedGen UID:
335284
Concept ID:
C1845847
Finding
Absence of fine and sharp appearance of brows, nose, lips, mouth, and chin, usually because of rounded and heavy features or thickened skin with or without thickening of subcutaneous and bony tissues.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVNeonatal encephalomyopathy-cardiomyopathy-respiratory distress syndrome

Professional guidelines

PubMed

Sweet DG, Carnielli VP, Greisen G, Hallman M, Klebermass-Schrehof K, Ozek E, Te Pas A, Plavka R, Roehr CC, Saugstad OD, Simeoni U, Speer CP, Vento M, Visser GHA, Halliday HL
Neonatology 2023;120(1):3-23. Epub 2023 Feb 15 doi: 10.1159/000528914. PMID: 36863329Free PMC Article
Lees CC, Romero R, Stampalija T, Dall'Asta A, DeVore GA, Prefumo F, Frusca T, Visser GHA, Hobbins JC, Baschat AA, Bilardo CM, Galan HL, Campbell S, Maulik D, Figueras F, Lee W, Unterscheider J, Valensise H, Da Silva Costa F, Salomon LJ, Poon LC, Ferrazzi E, Mari G, Rizzo G, Kingdom JC, Kiserud T, Hecher K
Am J Obstet Gynecol 2022 Mar;226(3):366-378. Epub 2022 Jan 10 doi: 10.1016/j.ajog.2021.11.1357. PMID: 35026129Free PMC Article
Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Te Pas A, Plavka R, Roehr CC, Saugstad OD, Simeoni U, Speer CP, Vento M, Visser GHA, Halliday HL
Neonatology 2019;115(4):432-450. Epub 2019 Apr 11 doi: 10.1159/000499361. PMID: 30974433Free PMC Article

Recent clinical studies

Etiology

Schulzke SM, Stoecklin B
Paediatr Anaesth 2022 Feb;32(2):363-371. Epub 2021 Dec 15 doi: 10.1111/pan.14369. PMID: 34878697Free PMC Article
Reynolds P, Bustani P, Darby C, Fernandez Alvarez JR, Fox G, Jones S, Robertson SJ, Vasu V, Roehr CC
Neonatology 2021;118(5):586-592. Epub 2021 Sep 2 doi: 10.1159/000518396. PMID: 34515188
Raimondi F, Migliaro F, Corsini I, Meneghin F, Dolce P, Pierri L, Perri A, Aversa S, Nobile S, Lama S, Varano S, Savoia M, Gatto S, Leonardi V, Capasso L, Carnielli VP, Mosca F, Dani C, Vento G, Lista G
Pediatrics 2021 Apr;147(4) Epub 2021 Mar 9 doi: 10.1542/peds.2020-030528. PMID: 33688032
Wynne K, Rowe C, Delbridge M, Watkins B, Brown K, Addley J, Woods A, Murray H
F1000Res 2020;9 Epub 2020 Mar 30 doi: 10.12688/f1000research.20550.1. PMID: 32269758Free PMC Article
Edwards MO, Kotecha SJ, Kotecha S
Paediatr Respir Rev 2013 Mar;14(1):29-36; quiz 36-7. Epub 2012 Mar 2 doi: 10.1016/j.prrv.2012.02.002. PMID: 23347658

Diagnosis

Welde MA, Sanford CB, Mangum M, Paschal C, Jnah AJ
Neonatal Netw 2021 Aug 1;40(5):295-304. doi: 10.1891/11-T-696. PMID: 34518381
Raimondi F, Migliaro F, Corsini I, Meneghin F, Dolce P, Pierri L, Perri A, Aversa S, Nobile S, Lama S, Varano S, Savoia M, Gatto S, Leonardi V, Capasso L, Carnielli VP, Mosca F, Dani C, Vento G, Lista G
Pediatrics 2021 Apr;147(4) Epub 2021 Mar 9 doi: 10.1542/peds.2020-030528. PMID: 33688032
Rocha G, Soares P, Gonçalves A, Silva AI, Almeida D, Figueiredo S, Pissarra S, Costa S, Soares H, Flôr-de-Lima F, Guimarães H
Can Respir J 2018;2018:7472964. Epub 2018 Aug 13 doi: 10.1155/2018/7472964. PMID: 30186538Free PMC Article
McPherson C, Wambach JA
Neonatal Netw 2018 May 1;37(3):169-177. doi: 10.1891/0730-0832.37.3.169. PMID: 29789058
Edwards MO, Kotecha SJ, Kotecha S
Paediatr Respir Rev 2013 Mar;14(1):29-36; quiz 36-7. Epub 2012 Mar 2 doi: 10.1016/j.prrv.2012.02.002. PMID: 23347658

Therapy

Schulzke SM, Stoecklin B
Paediatr Anaesth 2022 Feb;32(2):363-371. Epub 2021 Dec 15 doi: 10.1111/pan.14369. PMID: 34878697Free PMC Article
Ho JJ, Subramaniam P, Davis PG
Cochrane Database Syst Rev 2020 Oct 15;10(10):CD002271. doi: 10.1002/14651858.CD002271.pub3. PMID: 33058208Free PMC Article
Behnke J, Lemyre B, Czernik C, Zimmer KP, Ehrhardt H, Waitz M
Dtsch Arztebl Int 2019 Mar 8;116(11):177-183. doi: 10.3238/arztebl.2019.0177. PMID: 31014448Free PMC Article
Fletcher K, Chapman R, Keene S
Semin Perinatol 2018 Mar;42(2):68-79. Epub 2018 Jan 12 doi: 10.1053/j.semperi.2017.12.002. PMID: 29336834
Polin RA, Carlo WA; Committee on Fetus and Newborn; American Academy of Pediatrics
Pediatrics 2014 Jan;133(1):156-63. Epub 2013 Dec 30 doi: 10.1542/peds.2013-3443. PMID: 24379227

Prognosis

Hessami K, Homayoon N, Hashemi A, Vafaei H, Kasraeian M, Asadi N
J Matern Fetal Neonatal Med 2022 Aug;35(15):2936-2941. Epub 2020 Aug 16 doi: 10.1080/14767058.2020.1806817. PMID: 32799712
Mwita S, Jande M, Katabalo D, Kamala B, Dewey D
World J Pediatr 2021 Apr;17(2):131-140. Epub 2021 Jan 3 doi: 10.1007/s12519-020-00398-6. PMID: 33389692
Condò V, Cipriani S, Colnaghi M, Bellù R, Zanini R, Bulfoni C, Parazzini F, Mosca F
J Matern Fetal Neonatal Med 2017 Jun;30(11):1267-1272. Epub 2016 Aug 2 doi: 10.1080/14767058.2016.1210597. PMID: 27399933
Edwards MO, Kotecha SJ, Kotecha S
Paediatr Respir Rev 2013 Mar;14(1):29-36; quiz 36-7. Epub 2012 Mar 2 doi: 10.1016/j.prrv.2012.02.002. PMID: 23347658
Rokade ML, Rananavare RV, Shetty DS, Saifi S
Indian J Pediatr 2005 Mar;72(3):245-7. doi: 10.1007/BF02859267. PMID: 15812122

Clinical prediction guides

Ramaswamy VV, Abiramalatha T, Bandyopadhyay T, Boyle E, Roehr CC
Arch Dis Child Fetal Neonatal Ed 2022 Jul;107(4):393-397. Epub 2021 Oct 22 doi: 10.1136/archdischild-2021-322890. PMID: 34686533
Raimondi F, Migliaro F, Corsini I, Meneghin F, Pierri L, Salomè S, Perri A, Aversa S, Nobile S, Lama S, Varano S, Savoia M, Gatto S, Leonardi V, Capasso L, Carnielli VP, Mosca F, Dani C, Vento G, Dolce P, Lista G
Chest 2021 Dec;160(6):2178-2186. Epub 2021 Jul 19 doi: 10.1016/j.chest.2021.06.076. PMID: 34293317
Andrikopoulou M, Emeruwa UN, Ludwig E, Overton E, Gyamfi-Bannerman C
Am J Obstet Gynecol MFM 2021 Sep;3(5):100408. Epub 2021 May 28 doi: 10.1016/j.ajogmf.2021.100408. PMID: 34058419
Raimondi F, Migliaro F, Corsini I, Meneghin F, Dolce P, Pierri L, Perri A, Aversa S, Nobile S, Lama S, Varano S, Savoia M, Gatto S, Leonardi V, Capasso L, Carnielli VP, Mosca F, Dani C, Vento G, Lista G
Pediatrics 2021 Apr;147(4) Epub 2021 Mar 9 doi: 10.1542/peds.2020-030528. PMID: 33688032
Wheeler CR, Smallwood CD
Respir Care 2020 May;65(5):693-704. Epub 2020 Mar 24 doi: 10.4187/respcare.07720. PMID: 32209710

Recent systematic reviews

Gallo DM, Romero R, Bosco M, Gotsch F, Jaiman S, Jung E, Suksai M, Ramón Y Cajal CL, Yoon BH, Chaiworapongsa T
Am J Obstet Gynecol 2023 May;228(5S):S1158-S1178. Epub 2023 Apr 1 doi: 10.1016/j.ajog.2022.11.1283. PMID: 37012128Free PMC Article
Malaza N, Masete M, Adam S, Dias S, Nyawo T, Pheiffer C
Int J Environ Res Public Health 2022 Aug 31;19(17) doi: 10.3390/ijerph191710846. PMID: 36078559Free PMC Article
Ye W, Luo C, Huang J, Li C, Liu Z, Liu F
BMJ 2022 May 25;377:e067946. doi: 10.1136/bmj-2021-067946. PMID: 35613728Free PMC Article
McGoldrick E, Stewart F, Parker R, Dalziel SR
Cochrane Database Syst Rev 2020 Dec 25;12(12):CD004454. doi: 10.1002/14651858.CD004454.pub4. PMID: 33368142Free PMC Article
Rabie N, Magann E, Steelman S, Ounpraseuth S
Ultrasound Obstet Gynecol 2017 Apr;49(4):442-449. doi: 10.1002/uog.15929. PMID: 27062200

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