U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Combined oxidative phosphorylation deficiency 59(COXPD59)

MedGen UID:
1845781
Concept ID:
C5882730
Disease or Syndrome
Synonym: COXPD59
 
Gene (location): MRPL39 (21q21.3)
 
Monarch Initiative: MONDO:0957992
OMIM®: 620646

Definition

Combined oxidative phosphorylation deficiency-59 (COXPD59) may present as a lethal infantile form of Leigh syndrome (see 256000) or as a milder disorder with hypertrophic cardiomyopathy, lactic acidosis, attention deficit-hyperactivity disorder (ADHD) and survival into adulthood (summary by Amarasekera et al., 2023). For a discussion of genetic heterogeneity of combined oxidative phosphorylation deficiency, see COXPD1 (609060). [from OMIM]

Clinical features

From HPO
Dicarboxylic aciduria
MedGen UID:
343550
Concept ID:
C1856432
Finding
An increased concentration of dicarboxylic 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.
Congestive heart failure
MedGen UID:
9169
Concept ID:
C0018802
Disease or Syndrome
The presence of an abnormality of cardiac function that is responsible for the failure of the heart to pump blood at a rate that is commensurate with the needs of the tissues or a state in which abnormally elevated filling pressures are required for the heart to do so. Heart failure is frequently related to a defect in myocardial contraction.
Severely reduced left ventricular ejection fraction
MedGen UID:
868396
Concept ID:
C4022790
Finding
A large reduction in the fraction of blood pumped from the left ventricle with each cardiac cycle. The normal range in adults is at over 50 percent, and a severe reduction is defined as less than 30 percent.
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.
Cholelithiasis
MedGen UID:
3039
Concept ID:
C0008350
Disease or Syndrome
Hard, pebble-like deposits that form within the gallbladder.
Vomiting
MedGen UID:
12124
Concept ID:
C0042963
Sign or Symptom
Forceful ejection of the contents of the stomach through the mouth by means of a series of involuntary spasmic contractions.
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.
Cerebral edema
MedGen UID:
2337
Concept ID:
C0006114
Pathologic Function
Abnormal accumulation of fluid in the brain.
Apathy
MedGen UID:
39083
Concept ID:
C0085632
Mental or Behavioral Dysfunction
Apathy is a quantitative reduction of interest, motivation and the initiation and persistence of goal-directed behavior, where often the accompanying emotions, thoughts, and social interactions are also diminished. The individual is typically non-reactive to provocations, positive or negative, and appears to not care. Distinguished from lethargy which involves lack of physical or mental energy.
Migraine
MedGen UID:
57451
Concept ID:
C0149931
Disease or Syndrome
Migraine is a chronic neurological disorder characterized by episodic attacks of headache and associated symptoms.
CNS demyelination
MedGen UID:
137898
Concept ID:
C0338474
Disease or Syndrome
A loss of myelin from nerve fibers in the central nervous system.
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.
Attention deficit hyperactivity disorder
MedGen UID:
220387
Concept ID:
C1263846
Mental or Behavioral Dysfunction
Attention-deficit/hyperactivity disorder (ADHD) is a behavioral disorder that typically begins in childhood and is characterized by a short attention span (inattention), an inability to be calm and stay still (hyperactivity), and poor impulse control (impulsivity). Some people with ADHD have problems with only inattention or with hyperactivity and impulsivity, but most have problems related to all three features.\n\nIn people with ADHD, the characteristic behaviors are frequent and severe enough to interfere with the activities of daily living such as school, work, and relationships with others. Because of an inability to stay focused on tasks, people with inattention may be easily distracted, forgetful, avoid tasks that require sustained attention, have difficulty organizing tasks, or frequently lose items.\n\nHyperactivity is usually shown by frequent movement. Individuals with this feature often fidget or tap their foot when seated, leave their seat when it is inappropriate to do so (such as in the classroom), or talk a lot and interrupt others.\n\nIn most affected individuals, ADHD continues throughout life, but in about one-third of individuals, signs and symptoms of ADHD go away by adulthood.\n\nImpulsivity can result in hasty actions without thought for the consequences. Individuals with poor impulse control may have difficulty waiting for their turn, deferring to others, or considering their actions before acting.\n\nMore than two-thirds of all individuals with ADHD have additional conditions, including insomnia, mood or anxiety disorders, learning disorders, or substance use disorders. Affected individuals may also have autism spectrum disorder, which is characterized by impaired communication and social interaction, or Tourette syndrome, which is a disorder characterized by repetitive and involuntary movements or noises called tics.
Developmental regression
MedGen UID:
324613
Concept ID:
C1836830
Disease or Syndrome
Loss of developmental skills, as manifested by loss of developmental milestones.
Abnormal basal ganglia MRI signal intensity
MedGen UID:
868351
Concept ID:
C4022745
Anatomical Abnormality
A deviation from normal signal on magnetic resonance imaging (MRI) of the basal ganglia.
Elevated brain lactate level by MRS
MedGen UID:
868368
Concept ID:
C4022762
Finding
An increase in the level of lactate in the brain identified by magnetic resonance spectroscopy (MRS).
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.
Apnea
MedGen UID:
2009
Concept ID:
C0003578
Sign or Symptom
Lack of breathing with no movement of the respiratory muscles and no exchange of air in the lungs. This term refers to a disposition to have recurrent episodes of apnea rather than to a single event.
Hyper-beta-alaninemia
MedGen UID:
75702
Concept ID:
C0268630
Disease or Syndrome
An increased concentration of alanine in the blood.
Ketotic hypoglycemia
MedGen UID:
543512
Concept ID:
C0271713
Disease or Syndrome
Low blood glucose is accompanied by elevated levels of ketone bodies in the body.
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).
Retinal degeneration
MedGen UID:
48432
Concept ID:
C0035304
Finding
A nonspecific term denoting degeneration of the retinal pigment epithelium and/or retinal photoreceptor cells.
Strabismus
MedGen UID:
21337
Concept ID:
C0038379
Disease or Syndrome
A misalignment of the eyes so that the visual axes deviate from bifoveal fixation. The classification of strabismus may be based on a number of features including the relative position of the eyes, whether the deviation is latent or manifest, intermittent or constant, concomitant or otherwise and according to the age of onset and the relevance of any associated refractive error.
Decreased activity of the pyruvate dehydrogenase complex
MedGen UID:
326605
Concept ID:
C1839888
Finding
Decreased activity of mitochondrial complex I
MedGen UID:
393796
Concept ID:
C2677650
Finding
A reduction in the activity of the mitochondrial respiratory chain complex I, which is part of the electron transport chain in mitochondria.
Decreased activity of mitochondrial complex IV
MedGen UID:
866520
Concept ID:
C4020800
Finding
A reduction in the activity of the mitochondrial respiratory chain complex IV, which is part of the electron transport chain in mitochondria.

Professional guidelines

PubMed

Zhang W, Li D, Li B, Chu X, Kong B
Int Immunopharmacol 2023 Mar;116:109770. Epub 2023 Feb 4 doi: 10.1016/j.intimp.2023.109770. PMID: 36746021
Maeda S, Mure K, Mugitani K, Watanabe Y, Iwane M, Mohara O, Takeshita T
Alcohol Clin Exp Res 2014 Jun;38(6):1559-66. Epub 2014 Apr 17 doi: 10.1111/acer.12406. PMID: 24749767
Wolf NI, Smeitink JA
Neurology 2002 Nov 12;59(9):1402-5. doi: 10.1212/01.wnl.0000031795.91814.d8. PMID: 12427891

Recent clinical studies

Etiology

Zhang Y, Liu X, Wiggins KL, Kurniansyah N, Guo X, Rodrigue AL, Zhao W, Yanek LR, Ratliff SM, Pitsillides A, Aguirre Patiño JS, Sofer T, Arking DE, Austin TR, Beiser AS, Blangero J, Boerwinkle E, Bressler J, Curran JE, Hou L, Hughes TM, Kardia SLR, Launer LJ, Levy D, Mosley TH, Nasrallah IM, Rich SS, Rotter JI, Seshadri S, Tarraf W, González KA, Ramachandran V, Yaffe K, Nyquist PA, Psaty BM, DeCarli CS, Smith JA, Glahn DC, González HM, Bis JC, Fornage M, Heckbert SR, Fitzpatrick AL, Liu C, Satizabal CL; NHLBI Trans-Omics for Precision Medicine (TOPMed) program, Mitochondrial and Neurocognitive Working Groups
Neurology 2023 May 2;100(18):e1930-e1943. Epub 2023 Mar 16 doi: 10.1212/WNL.0000000000207157. PMID: 36927883Free PMC Article
Liu MY, Shao HD, Wu YY, Peng DL, Yu JW, Jia JP, Peng H, Li CR, Sulaiman A, Yu XY, Li CH, Huang WK
Plant Dis 2023 Jul;107(7):2070-2080. Epub 2023 Jul 6 doi: 10.1094/PDIS-08-22-1796-RE. PMID: 36691277
Kullmann S, Goj T, Veit R, Fritsche L, Wagner L, Schneeweiss P, Hoene M, Hoffmann C, Machann J, Niess A, Preissl H, Birkenfeld AL, Peter A, Häring HU, Fritsche A, Moller A, Weigert C, Heni M
JCI Insight 2022 Sep 22;7(18) doi: 10.1172/jci.insight.161498. PMID: 36134657Free PMC Article
Kirola L, Mukherjee A, Mutsuddi M
Mol Neurobiol 2022 Sep;59(9):5673-5694. Epub 2022 Jun 30 doi: 10.1007/s12035-022-02934-z. PMID: 35768750
Ciregia F
Adv Exp Med Biol 2019;1158:59-70. doi: 10.1007/978-981-13-8367-0_4. PMID: 31452135

Diagnosis

Kullmann S, Goj T, Veit R, Fritsche L, Wagner L, Schneeweiss P, Hoene M, Hoffmann C, Machann J, Niess A, Preissl H, Birkenfeld AL, Peter A, Häring HU, Fritsche A, Moller A, Weigert C, Heni M
JCI Insight 2022 Sep 22;7(18) doi: 10.1172/jci.insight.161498. PMID: 36134657Free PMC Article
Sommerville EW, Ng YS, Alston CL, Dallabona C, Gilberti M, He L, Knowles C, Chin SL, Schaefer AM, Falkous G, Murdoch D, Longman C, de Visser M, Bindoff LA, Rawles JM, Dean JCS, Petty RK, Farrugia ME, Haack TB, Prokisch H, McFarland R, Turnbull DM, Donnini C, Taylor RW, Gorman GS
JAMA Neurol 2017 Jun 1;74(6):686-694. doi: 10.1001/jamaneurol.2016.4357. PMID: 28395030Free PMC Article
Ulrick N, Goldstein A, Simons C, Taft RJ, Helman G, Pizzino A, Bloom M, Vogt J, Pysden K, Diodato D, Martinelli D, Monavari A, Buhas D, van Karnebeek CD, Dorboz I, Boespflug-Tanguy O, Rodriguez D, Tétreault M, Majewski J, Bernard G, Ng YS; Care4Rare Canada Consortium, McFarland R, Vanderver A
Pediatr Neurol 2017 Jan;66:59-62. Epub 2016 Sep 13 doi: 10.1016/j.pediatrneurol.2016.09.003. PMID: 27843092
Holdsworth SJ, Yeom K, Skare S, Gentles AJ, Barnes PD, Bammer R
AJNR Am J Neuroradiol 2011 Aug;32(7):1274-9. Epub 2011 May 19 doi: 10.3174/ajnr.A2481. PMID: 21596809Free PMC Article
Kemp GJ, Roberts N, Bimson WE, Bakran A, Harris PL, Gilling-Smith GL, Brennan J, Rankin A, Frostick SP
J Vasc Surg 2001 Dec;34(6):1103-10. doi: 10.1067/mva.2001.117152. PMID: 11743568

Therapy

Zhang Y, Liu X, Wiggins KL, Kurniansyah N, Guo X, Rodrigue AL, Zhao W, Yanek LR, Ratliff SM, Pitsillides A, Aguirre Patiño JS, Sofer T, Arking DE, Austin TR, Beiser AS, Blangero J, Boerwinkle E, Bressler J, Curran JE, Hou L, Hughes TM, Kardia SLR, Launer LJ, Levy D, Mosley TH, Nasrallah IM, Rich SS, Rotter JI, Seshadri S, Tarraf W, González KA, Ramachandran V, Yaffe K, Nyquist PA, Psaty BM, DeCarli CS, Smith JA, Glahn DC, González HM, Bis JC, Fornage M, Heckbert SR, Fitzpatrick AL, Liu C, Satizabal CL; NHLBI Trans-Omics for Precision Medicine (TOPMed) program, Mitochondrial and Neurocognitive Working Groups
Neurology 2023 May 2;100(18):e1930-e1943. Epub 2023 Mar 16 doi: 10.1212/WNL.0000000000207157. PMID: 36927883Free PMC Article
Zhang W, Li D, Li B, Chu X, Kong B
Int Immunopharmacol 2023 Mar;116:109770. Epub 2023 Feb 4 doi: 10.1016/j.intimp.2023.109770. PMID: 36746021
Kullmann S, Goj T, Veit R, Fritsche L, Wagner L, Schneeweiss P, Hoene M, Hoffmann C, Machann J, Niess A, Preissl H, Birkenfeld AL, Peter A, Häring HU, Fritsche A, Moller A, Weigert C, Heni M
JCI Insight 2022 Sep 22;7(18) doi: 10.1172/jci.insight.161498. PMID: 36134657Free PMC Article
O'Connell TM, Logsdon DL, Payne RM
Mol Genet Metab 2022 Aug;136(4):306-314. Epub 2022 Jun 13 doi: 10.1016/j.ymgme.2022.06.002. PMID: 35798654
Chen J, Jin X, Shen Z, Mei Y, Zhu J, Zhang X, Liang G, Zheng X
Med Oncol 2021 Apr 21;38(6):59. doi: 10.1007/s12032-021-01505-x. PMID: 33880669

Prognosis

O'Connell TM, Logsdon DL, Payne RM
Mol Genet Metab 2022 Aug;136(4):306-314. Epub 2022 Jun 13 doi: 10.1016/j.ymgme.2022.06.002. PMID: 35798654
da Rosa R, Dambrós BP, Höehr de Moraes M, Grand L, Jacolot M, Popowycz F, Steindel M, Schenkel EP, Campos Bernardes LS
Bioorg Chem 2022 Feb;119:105492. Epub 2021 Nov 15 doi: 10.1016/j.bioorg.2021.105492. PMID: 34838333
Hayhurst H, de Coo IFM, Piekutowska-Abramczuk D, Alston CL, Sharma S, Thompson K, Rius R, He L, Hopton S, Ploski R, Ciara E, Lake NJ, Compton AG, Delatycki MB, Verrips A, Bonnen PE, Jones SA, Morris AA, Shakespeare D, Christodoulou J, Wesol-Kucharska D, Rokicki D, Smeets HJM, Pronicka E, Thorburn DR, Gorman GS, McFarland R, Taylor RW, Ng YS
Ann Clin Transl Neurol 2019 Mar;6(3):515-524. Epub 2019 Feb 17 doi: 10.1002/acn3.725. PMID: 30911575Free PMC Article
Sommerville EW, Ng YS, Alston CL, Dallabona C, Gilberti M, He L, Knowles C, Chin SL, Schaefer AM, Falkous G, Murdoch D, Longman C, de Visser M, Bindoff LA, Rawles JM, Dean JCS, Petty RK, Farrugia ME, Haack TB, Prokisch H, McFarland R, Turnbull DM, Donnini C, Taylor RW, Gorman GS
JAMA Neurol 2017 Jun 1;74(6):686-694. doi: 10.1001/jamaneurol.2016.4357. PMID: 28395030Free PMC Article
Lee HN, Eom S, Kim SH, Kang HC, Lee JS, Kim HD, Lee YM
Pediatr Neurol 2016 Nov;64:59-65. Epub 2016 Aug 26 doi: 10.1016/j.pediatrneurol.2016.08.016. PMID: 27671241

Clinical prediction guides

Zhang Y, Liu X, Wiggins KL, Kurniansyah N, Guo X, Rodrigue AL, Zhao W, Yanek LR, Ratliff SM, Pitsillides A, Aguirre Patiño JS, Sofer T, Arking DE, Austin TR, Beiser AS, Blangero J, Boerwinkle E, Bressler J, Curran JE, Hou L, Hughes TM, Kardia SLR, Launer LJ, Levy D, Mosley TH, Nasrallah IM, Rich SS, Rotter JI, Seshadri S, Tarraf W, González KA, Ramachandran V, Yaffe K, Nyquist PA, Psaty BM, DeCarli CS, Smith JA, Glahn DC, González HM, Bis JC, Fornage M, Heckbert SR, Fitzpatrick AL, Liu C, Satizabal CL; NHLBI Trans-Omics for Precision Medicine (TOPMed) program, Mitochondrial and Neurocognitive Working Groups
Neurology 2023 May 2;100(18):e1930-e1943. Epub 2023 Mar 16 doi: 10.1212/WNL.0000000000207157. PMID: 36927883Free PMC Article
O'Connell TM, Logsdon DL, Payne RM
Mol Genet Metab 2022 Aug;136(4):306-314. Epub 2022 Jun 13 doi: 10.1016/j.ymgme.2022.06.002. PMID: 35798654
Sommerville EW, Ng YS, Alston CL, Dallabona C, Gilberti M, He L, Knowles C, Chin SL, Schaefer AM, Falkous G, Murdoch D, Longman C, de Visser M, Bindoff LA, Rawles JM, Dean JCS, Petty RK, Farrugia ME, Haack TB, Prokisch H, McFarland R, Turnbull DM, Donnini C, Taylor RW, Gorman GS
JAMA Neurol 2017 Jun 1;74(6):686-694. doi: 10.1001/jamaneurol.2016.4357. PMID: 28395030Free PMC Article
Lee HN, Eom S, Kim SH, Kang HC, Lee JS, Kim HD, Lee YM
Pediatr Neurol 2016 Nov;64:59-65. Epub 2016 Aug 26 doi: 10.1016/j.pediatrneurol.2016.08.016. PMID: 27671241
Holdsworth SJ, Yeom K, Skare S, Gentles AJ, Barnes PD, Bammer R
AJNR Am J Neuroradiol 2011 Aug;32(7):1274-9. Epub 2011 May 19 doi: 10.3174/ajnr.A2481. PMID: 21596809Free 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...