title: On the many faces of Leber hereditary optic neuropathy.
abstract: Leber hereditary optic neuropathy (LHON) is a maternally inherited disorder, associated with mutations in the mitochondrial DNA, which is notorious for its aspecific presentations. Two pedigrees are described with cases that are atypical for LHON with respect to sex, age of onset, interval between the eyes becoming affected, course of the disease, concomitant disorders, additional test results, final visual acuity, and/or results of mtDNA analysis. Moreover, the pedigrees themselves did not suggest maternal inheritance. We analysed the diagnostic and clinical genetic difficulties related to the atypical aspects of these pedigrees. We conclude that mtDNA analysis is justified in every case of optic nerve atrophy with no clear cause. Identification of one of the three LHON specifically associated mtDNA mutations is essential to confirm the diagnosis.
authors.affiliation: Department of Clinical Genetics, Free University Hospital, Amsterdam, The Netherlands.
authors.forename: R J
authors.initials: RJ
authors.lastname: Oostra
authors.forename: N T
authors.initials: NT
authors.lastname: Tijmes
authors.forename: J M
authors.initials: JM
authors.lastname: Cobben
authors.forename: P A
authors.initials: PA
authors.lastname: Bolhuis
authors.forename: B P
authors.initials: BP
authors.lastname: van Nesselrooij
authors.forename: W A
authors.initials: WA
authors.lastname: Houtman
authors.forename: M M
authors.initials: MM
authors.lastname: de Kok-Nazaruk
authors.forename: E M
authors.initials: EM
authors.lastname: Bleeker-Wagemakers
mesh_terms: D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D004272:DNA, Mitochondrial / Q000235:genetics; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009154:Mutation; D015418:Optic Atrophies, Hereditary / Q000175:diagnosis / Q000235:genetics*; D009896:Optic Atrophy / Q000175:diagnosis* / Q000235:genetics; D010375:Pedigree
chemical_list: D004272:DNA, Mitochondrial