title: Oxidative phosphorylation defect associated with primary adrenal insufficiency.
abstract: An 18-month-old girl with an oxidative phosphorylation defect had neonatal onset of chronic lactic acidosis, lipid storage myopathy, bilateral cataracts, and primary adrenal insufficiency. Chronic lactic acidosis responded to treatment with dichloroacetate. Sequential muscle biopsies demonstrated resolution of the lipid storage myopathy associated with the return to normal muscle free carnitine levels. This case demonstrates a new clinical phenotype associated with a defect in oxidative phosphorylation and the need to consider mitochondrial disorders in the differential diagnosis of primary adrenal insufficiency in childhood.
authors.affiliation: Department of Medicine, Children's Hospital, Boston, Massachusetts 02115, USA.
authors.forename: K
authors.initials: K
authors.lastname: North
authors.forename: M S
authors.initials: MS
authors.lastname: Korson
authors.forename: N
authors.initials: N
authors.lastname: Krawiecki
authors.forename: J M
authors.initials: JM
authors.lastname: Shoffner
authors.forename: I A
authors.initials: IA
authors.lastname: Holm
mesh_terms: D000140:Acidosis, Lactic / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D000324:Adrenocorticotropic Hormone / Q000172:deficiency*; D002386:Cataract / Q000150:complications; D003999:Dichloroacetic Acid / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008052:Lipid Metabolism, Inborn Errors / Q000150:complications / Q000378:metabolism*; D008931:Mitochondria, Muscle / Q000378:metabolism*; D010085:Oxidative Phosphorylation; D010641:Phenotype
chemical_list: D000324:Adrenocorticotropic Hormone; D003999:Dichloroacetic Acid