title: Leigh-like syndrome with the T8993G mutation in the mitochondrial ATPase 6 gene: long-term follow-up discloses a slowly progressive course.
abstract: We describe the long-term clinical outcome of a patient with Leigh-like syndrome presenting as an early onset encephalopathy and peripheral neuropathy caused by the T8993G mutation in the mitochondrial DNA (mtDNA). Clinical follow-up for 20 years revealed a peculiar pattern of slow disease progression, characterized by the addition of new minor deficits, while worsening of previous symptoms was mild. Brain MRI revealed cerebellar atrophy, diffuse demyelination of corona radiata and parietal white matter, and bilateral and symmetrical putaminal lesions. The proportion of mutant mtDNAs in blood was 72% (+/-0.02%) and in skeletal muscle was 81% (+/-0.4%). Leigh-like syndrome caused by the T8993G mtDNA mutation is a progressive disease, although not necessarily associated with an aggressive clinical course.
authors.affiliation: Division of Neurology, Department of Neurosciences, Faculty of Medicine of Ribeirão Preto, São Paulo University, Ribeirão Preto-São Paulo, Brazil. csobreira@fmrp.usp.br
authors.forename: Cláudia
authors.initials: C
authors.lastname: Sobreira
authors.forename: Wilson
authors.initials: W
authors.lastname: Marques
authors.forename: Octávio M
authors.initials: OM
authors.lastname: Pontes Neto
authors.forename: Antônio Carlos
authors.initials: AC
authors.lastname: Santos
authors.forename: João M
authors.initials: JM
authors.lastname: Pina Neto
authors.forename: Amilton A
authors.initials: AA
authors.lastname: Barreira
mesh_terms: D000328:Adult; D001774:Blood Chemical Analysis; D001921:Brain / Q000473:pathology; D004252:DNA Mutational Analysis; D004272:DNA, Mitochondrial / Q000235:genetics*; D018450:Disease Progression; D005500:Follow-Up Studies; D050259:Genes, Mitochondrial; D006801:Humans; D007888:Leigh Disease / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D025261:Mitochondrial Proton-Translocating ATPases / Q000235:genetics*; D018482:Muscle, Skeletal / Q000737:chemistry; D020125:Mutation, Missense; D013577:Syndrome; D055815:Young Adult
chemical_list: D004272:DNA, Mitochondrial; C412204:ATP synthase subunit 6; D025261:Mitochondrial Proton-Translocating ATPases