Adrenal Insufficiency in Mitochondrial Disease: A Rare Case of GFER-Related Mitochondrial Encephalomyopathy and Review of the Literature

J Child Neurol. 2016 Feb;31(2):190-4. doi: 10.1177/0883073815587327. Epub 2015 May 26.

Abstract

GFER-related mitochondrial encephalomyopathy has been previously described only in 3 siblings of a consanguineous Moroccan family. Their phenotype included congenital cataracts, hypotonia, developmental delay, and sensorineural hearing loss. Multiple mitochondrial respiratory chain complex deficiencies were identified on muscle biopsy. We describe a now-19-year-old woman with adrenal insufficiency, lactic acidosis, congenital cataracts, and respiratory insufficiency secondary to mitochondrial disorder, who was reported by North et al (1996) as a toddler. Compound heterozygous GFER mutations c.373C>T (Q125X) and c.581G>A (R194 H) were recently discovered in this patient. The purpose of this report is (1) to expand the phenotype this ultra-rare disorder and (2) to provide a review of the literature describing the unique finding of adrenal insufficiency in patients with molecularly confirmed disorders of mitochondrial metabolism.

Keywords: congenital cataracts; lactic acidosis; mitochondrial DNA (mtDNA) deletion; next generation panel.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acidosis, Lactic / genetics*
  • Acidosis, Lactic / pathology
  • Acidosis, Lactic / physiopathology
  • Adrenal Insufficiency / genetics*
  • Adrenal Insufficiency / pathology
  • Adrenal Insufficiency / physiopathology
  • Cataract / genetics*
  • Cataract / pathology
  • Cataract / physiopathology
  • Consanguinity
  • Cytochrome Reductases / genetics*
  • Family
  • Female
  • Humans
  • Mitochondria / pathology
  • Mitochondrial Diseases / genetics*
  • Mitochondrial Diseases / pathology
  • Mitochondrial Diseases / physiopathology
  • Morocco
  • Oxidoreductases Acting on Sulfur Group Donors
  • Phenotype
  • Young Adult

Substances

  • Cytochrome Reductases
  • GFER protein, human
  • Oxidoreductases Acting on Sulfur Group Donors