High incidence and variable clinical outcome of cardiac hypertrophy due to ACAD9 mutations in childhood.

Abstract

Acyl-CoA dehydrogenase family, member 9 (ACAD9) mutation is a frequent, usually fatal cause of early-onset cardiac hypertrophy and mitochondrial respiratory chain complex I deficiency in early childhood. We retrospectively studied a series of 20 unrelated children with cardiac hypertrophy and isolated complex I deficiency and identified compound heterozygosity for missense, splice site or frame shift ACAD9 variants in 8/20 patients (40%). Age at onset ranged from neonatal period to 9 years and 5/8 died in infancy. Heart transplantation was possible in 3/8. Two of them survived and one additional patient improved spontaneously. Importantly, the surviving patients later developed delayed-onset neurologic or muscular symptoms, namely cognitive impairment, seizures, muscle weakness and exercise intolerance. Other organ involvement included proximal tubulopathy, renal failure, secondary ovarian failure and optic atrophy. We conclude that ACAD9 mutation is the most frequent cause of cardiac hypertrophy and isolated complex I deficiency. Heart transplantation in children surviving neonatal period should be considered with caution, as delayed-onset muscle and brain involvement of various severity may occur, even if absent prior to transplantation.

• Authors: Marie Collet, Zahra Assouline, Damien Bonnet, Marlène Rio, Franck Iserin, Daniel Sidi, Alice Goldenberg, Caroline Lardennois, Metodi Dimitrov Metodiev, Birgit Haberberger, Tobias Haack, Arnold Munnich, Holger Prokisch, Agnès Rötig
• Journal: European journal of human genetics : EJHG (Eur J Hum Genet) Vol. 24 Issue 8 Pg. 1112-6 (08 2016) ISSN: 1476-5438 [Electronic] England
• PMID: 26669660 (Publication Type: Journal Article)

Chemical References

• Acyl-CoA Dehydrogenases
• ACAD9 protein, human
• Electron Transport Complex I

Topics

• Acyl-CoA Dehydrogenases (genetics, metabolism)
• Cardiomegaly (genetics, pathology)
• Cells, Cultured
• Child
• Child, Preschool
• Electron Transport Complex I (deficiency, genetics)
• Female
• Frameshift Mutation
• Humans
• Infant
• Male
• Mitochondrial Diseases (genetics, pathology)
• Mutation Rate
• Mutation, Missense
• Syndrome