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Case Reports
. 2024 Apr 29;86(6):3753-3756.
doi: 10.1097/MS9.0000000000002096. eCollection 2024 Jun.

Complex mitochondrial disease caused by the mutation of COX10 in a toddler: a case-report study

Azita Tavasoli  1 , Maryam Kachuei  1 , Saeed Talebi  2 , Shayan Eghdami  3
Affiliations
Case Reports

Complex mitochondrial disease caused by the mutation of COX10 in a toddler: a case-report study

Azita Tavasoli et al. Ann Med Surg (Lond). .

Abstract

Introduction and importance: Cytochrome C oxidase (COX) deficiency is an uncommon inherited metabolic disorder. It is identified by a lack of the COX, also known as Complex IV. This enzyme plays a crucial role in the rate-limiting and oxygen-accepting step of the respiratory chain within the subcellular structures called mitochondria. The deficiency of COX can either be restricted to skeletal muscle tissues or can impact multiple tissues throughout the body.

Case presentation: A 3-year-old girl was admitted due to muscle weakness and a decline in developmental milestones 7 days after a significant stressor. Leukodystrophy was observed in the brain magnetic resonance imaging, and genome sequencing identified a homozygous mutation in exon 1 and 7 of chromosome 17. This mutation led to a deficiency in COX10, which is a component of mitochondrial complex IV.

Clinical discussion: In the medical field, inherited metabolic disorders can be complex to diagnose due to overlapping symptoms with other conditions. Mitochondria's oxidative phosphorylation system, including the COX enzyme complex, plays a crucial role in energy production. Mitochondrial disorders, including COX deficiency, can present at various stages of life with diverse symptoms. Treatment options focus on supportive care and potential benefits from supplements like coenzyme-Q10 and small-molecule therapies targeting mitochondrial function. Identifying genetic mutations is key for advancing treatments in this area.

Conclusion: This report presents a unique case of developmental regression and muscle weakness in a paediatric patient, which can be attributed to a rare occurrence of type 3 nuclear mitochondrial complex IV deficiency.

Keywords: COX10; case report; cytochrome c oxidase deficiency; mitochondrial complex IV; mitochondrial disorder.

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Conflict of interest statement

There is no ethical problem (approved by the research ethics committee of Iran University of Medical Sciences) or conflict of interest in our research.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
MRI (A) T2 and (B) T1 displaying diffuse leukodystrophy.
See this image and copyright information in PMC

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