Novel and lethal case of cardiac involvement in DNM1L mitochondrial encephalopathy

Am J Med Genet A. 2019 Dec;179(12):2486-2489. doi: 10.1002/ajmg.a.61371. Epub 2019 Oct 6.

Abstract

Pathogenic DNM1L mutations cause a mitochondrial disorder with a highly variable clinical phenotype characterized by developmental delay, hypotonia, seizures, microcephaly, poor feeding, ocular abnormalities, and dysarthria. We report the case of an 8-month-old female with autosomal dominant, de novo DNM1L c. 1228G>A (p. E410K) mutation and mitochondrial disorder, septo-optic dysplasia, hypotonia, developmental delay, elevated blood lactate, and severe mitochondrial cardiomyopathy leading to nonischemic congestive heart failure and cardiogenic shock resulting in death. This case suggests that cardiac involvement, previously undescribed, can be a clinically important feature of this syndrome and should be screened for at diagnosis.

Keywords: DNM1L; cardiac; cardiomyopathy; heart failure; mitochondrial encephalopathy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alleles
  • Biopsy
  • Child
  • DNA Mutational Analysis
  • Dynamins / genetics*
  • Female
  • Genetic Association Studies
  • Genetic Predisposition to Disease
  • Genotype
  • Heart Diseases / diagnosis*
  • Heart Diseases / genetics*
  • Humans
  • Immunohistochemistry
  • Male
  • Mitochondrial Encephalomyopathies / diagnosis*
  • Mitochondrial Encephalomyopathies / genetics*
  • Mutation*
  • Phenotype*

Substances

  • DNM1L protein, human
  • Dynamins

Supplementary concepts

  • Mitochondrial encephalopathy