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Infantile Leukoencephalopathy Owing to Mitochondrial Enzyme Dysfunction

Division of Neurology Division of Human and Molecular Genetics, the Children's Hospital of Philadelphia, St. Christopher's Hospital for Children, Philadelphia, PA, peter.kang{at}tch.harvard.edu

Jill V. Hunter, MD

Department of Radiology Division of Human and Molecular Genetics, the Children's Hospital of Philadelphia, St. Christopher's Hospital for Children, Philadelphia, PA

Joseph J. Melvin, DO

the Division of Neurology, Division of Human and Molecular Genetics, the Children's Hospital of Philadelphia, St. Christopher's Hospital for Children, Philadelphia, PA

Mary A. Selak, PhD

Division of Neonatology, Division of Human and Molecular Genetics, the Children's Hospital of Philadelphia, St. Christopher's Hospital for Children, Philadelphia, PA

Eric N. Faerber, MD

Department of Radiology, Division of Human and Molecular Genetics, the Children's Hospital of Philadelphia, St. Christopher's Hospital for Children, Philadelphia, PA

Edward M. Kaye, MD

Division of Neurology Division of Human and Molecular Genetics, the Children's Hospital of Philadelphia, St. Christopher's Hospital for Children, Philadelphia, PA

Mitochondrial disease is classically associated with deep gray-matter lesions. When white matter is involved, the lesions are typically subcortical and overshadowed by more significant disease in the gray matter. We report six infants in five families who developed neurodegenerative diseases characterized primarily by abnormalities in deep white-matter structures such as the periventricular region, internal capsule, and corpus callosum. Five patients had impairments of mitochondrial enzymes, including a pre-electron transport chain defect and defects in respiratory chain complexes I, III, and IV (cytochrome-c oxidase). One patient, the sibling of one of the others, was diagnosed clinically with complex III deficiency. These six patients, along with others in the literature, appear to represent a distinct syndrome of mitochondrial infantile leukoencephalopathy. Our observations suggest that infants with leukoencephalopathies, especially leukodystrophies, who do not have one of the more common causes of white-matter disease should be evaluated for mitochondrial dysfunction. (J Child Neurol 2002;17:421-428).

Journal of Child Neurology, Vol. 17, No. 6, 421-428 (2002)
DOI: 10.1177/088307380201700605


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