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General Principles of Medical Genetics
Mitochondrial DNA Abnormalities
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    Mitochondrial DNA Abnormalities

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    Each cell has several hundred mitochondria in its cytoplasm. Mitochondria contain DNA in a single circular chromosome that codes for 13 proteins, various RNAs, and several regulating enzymes. However, > 90% of mitochondrial proteins are coded by nuclear genes. For practical purposes, all mitochondria are inherited from the cytoplasm of the egg; thus, mitochondrial DNA comes only from the mother.

    Mitochondrial disorders (see also Inherited Disorders of Metabolism: Mitochondrial Oxidative Phosphorylation Disorders) can be due to mitochondrial or nuclear DNA abnormalities (eg, deletions, duplications, mutations). High-energy tissues (eg, muscle, heart, brain) are particularly at risk of malfunction due to mitochondrial abnormalities. Particular mitochondrial DNA abnormalities result in characteristic manifestations (see Table 2: General Principles of Medical Genetics: Mitochondrial DisordersTables). Mitochondrial disorders are equally common among males and females.

    Table 2

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    Mitochondrial Disorders

    Disorder

    Description

    Chronic progressive external ophthalmoplegia

    Progressive paralysis of the extraocular muscles usually preceded by bilateral, symmetric, progressive ptosis that begins months to years earlier

    Kearns-Sayre syndrome

    A multisystem variant of chronic progressive external ophthalmoplegia that also includes heart block, retinitis pigmentosa, and CNS degeneration

    Leber's hereditary optic neuropathy

    Variable but often devastating bilateral visual loss that often occurs in adolescents and that is due to a point mutation in mitochondrial DNA

    MERRF syndrome

    Myoclonic epilepsy, ragged red fibers, dementia, ataxia, and myopathy

    MELAS syndrome

    Mitochondrial encephalomyopathy, lactic acidosis, and strokelike episodes

    Pearson's syndrome

    Sideroblastic anemia, pancreatic insufficiency, and progressive liver disease that begins in the first few months of life and is frequently fatal in infants

    Mitochondrial abnormalities may occur in many common disorders such as some types of Parkinson's disease (which may involve large mitochondrial deletions in the cells of the basal ganglia) and many types of muscle disorders.

    Maternal inheritance patterns characterize abnormalities of mitochondrial DNA. Thus, all offspring of an affected female are at risk of inheriting the abnormality, but no offspring of an affected male are at risk. Variability in clinical manifestations is the rule and may be due in part to variable mixtures of inherited mutant and normal mitochondrial genomes within cells and tissues.

    Last full review/revision May 2007 by Judith G. Hall, MD

    Content last modified February 2012

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