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96 patient data entries in database for clusters 1 and 2.

Entry
#
Mutations
allele 1allele 2
Clinical representationSymptomsAge groupAge of onsetAge of patientAge of deathReference
260A467T2
G848S1
Refractory seizures, psychomotor regression, liver disease, Transient hypoglycemia, Transient lactic academia, Elevated CSF protein, presented with epilepsia partialis continua,
-intractable seizure
-epilepsia partialis
-liver dysfunction
-hypoglycemia
infantile
0.9n/a1.8Nguyen et al, 2005;

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111G848S1
A467T2
Onset at 6 months with FTT, dementia, hypotonia, seizures, hepatopathy, aplasia cutis, delayed myelinisation. Death at 15 months.
-delayed myelination
-failure to thrive
-hypotonic
-dementia
infantile
0.5n/a1.3de Vries et al, 2007;

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112G848S1
A467T2
Alpers, seizures, developmental delay, liver failure, hypotonia, impaired vision, renal stones, mtDNA depletion in muscle. 5% COX deficient fibers.
-liver failure
-hypotonic
-developmental delay
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
0.7n/an/aStewart et al, 2009;

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127L1113P1
A467T2
Encephalopathy, seizures, pancreatitis, hepatic failure, elevated transaminases, respiratory deficiency/failure, lactic acidosis, mycoplasma infection, pentobarbital induced liver failure. 57% mtDNA copy number in muscle, 78% mtDNA copy number in blood, Complex IV 20%.
-lactic acidosis
-liver failure
-encephalopathy
-pancreatitis
-respiratory deficiency
infantile
n/a1n/aTang et al, 2011;

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634G848S1
A467T2
Developmental delay, dementia, seizures, Alpers
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
2n/an/aWong et al, 2008;

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633G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, hypotonia, failure to thrive
-failure to thrive
-hypotonic
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
0.8n/an/aWong et al, 2008;

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133R1128H1
G517V2
Onset at 1 years with microcephaly, developmental delay/ dementia, and liver dysfunction. Authors reported as undiagnosed.
-liver dysfunction
-developmental delay
-dementia
-microcephaly
infantile
1n/an/aWong et al, 2008;

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134D1196N1
G517V2
Onset at 1 years with myopathy, developmental delay/ dementia, RRF, and elevated CK. Authors reported as undiagnosed.
-myopathy
-developmental delay
-dementia
infantile
1n/an/aWong et al, 2008;

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345G848S1
A467T2
presented with hypoglycemia, lactic acidosis, moderate ketosis and liver dysfunction, generalized hypotonia, progressive jaundice and abdominal distension with ascites, status epilepticus with generalized tonico-clonic seizures. She had an intermittent tremor, moderate truncal ataxia with a wide-based gait, myoclonic seizures, epilepsia partialis continua,
-lactic acidosis
-status epilepticus
-myoclonic seizures
-epilepsia partialis
-movement disorder (ataxia)
-liver dysfunction
-jaundice
-hypotonic
-ketosis
-hypoglycemia
-tremor
infantile
0.29n/a5Scalais et al, 2012;

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188A467T2
R852C1
G11D
reported as Alpers, onset at 2 years, presenting encephalopathy with epilepsy, hepatopathy. 22% mtDNA copy number in muscle.
-epilepsy
-encephalopathy
-Alpers syndrome
-developmental delay
infantile
2.25n/an/aAshley et al, 2008;

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198A467T2
T914P1
reported as Alpers, onset at 7 months, presenting encephalopathy with epilepsy, hepatopathy, and movement disorder (ataxia). 39% mtDNA copy number in muscle.
-epilepsy
-movement disorder (ataxia)
-encephalopathy
-Alpers syndrome
-developmental delay
infantile
0.58n/an/aAshley et al, 2008;

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200A467T2
T914P1
Epilepsy, myoclonus, and developmental delay.
-myoclonic seizures
-epilepsy
-developmental delay
infantile
n/a1n/aBlok et al, 2009;

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212A467T2
A957P1
Epilepsy, liver failure, occipital strokes, and growth retardation, death at age 1.
-epilepsy
-liver failure
-growth retardation
-retardation
-occipital strokes
infantile
n/an/a1Blok et al, 2009;

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631G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, Lactic acidosis, Cortical athrophy, hypoglycemia
-lactic acidosis
-developmental delay
-dementia
-Alpers syndrome
-hypoglycemia
-encephalopathy
-epilepsy
infantile
1.5n/an/aWong et al, 2008;

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630G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, Lactic acidosis, Stroke
-lactic acidosis
-stroke
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
2n/an/aWong et al, 2008;

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259A467T2
G848S1
Refractory seizures, psychomotor regression, liver disease, presented with liver failure
-intractable seizure
-liver failure
-liver dysfunction
infantile
1n/a1.3Nguyen et al, 2005;

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110A957P1
A467T2
Onset at 8 months with FTT, dementia, hypotonia, seizures, hepatopathy, aplasia cutis, delayed myelinisation. Death at 17 months.
-delayed myelination
-failure to thrive
-hypotonic
-dementia
infantile
0.6n/a1.5de Vries et al, 2007;

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629G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, Ataxia
-movement disorder (ataxia)
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
2n/an/aWong et al, 2008;

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340C1188R1
A467T2
developmental delay, prolonged generalized seizure, hypotonia, epilepsia partialis continua, congestive heart failure, respiratory difficulty, autopsy showed enlarged and yellow liver, symmetrical but multifocal ischemic encephalopathy with laminar necrosis and neuronal degeneration in the cerebral cortex, Mitochondrial DNA copy number in blood was 43% of control values
-epilepsia partialis
-hypotonic
-encephalopathy
-developmental delay
-assumed Alpers
infantile
0.75n/a1.17Khan et al, 2012;

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559G848S1
A467T2
Epilepsy, stroke-like episode.
-epilepsy
-stroke
infantile
0.6n/a0.6Tzoulis et al, 2014;

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542G848S1
A467T2
Ragged Red Fibers, COX-Deficient Fibers. The boy had feeding difficulties with failure to thrive since 3 months of age. Delayed motor development. general muscle weakness and ataxia. compromised liver function.
-movement disorder (ataxia)
-ragged red fibers
-muscle weakness
-failure to thrive
infantile
0.33n/a1.33Kollberg et al, 2006;

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284K1191R1
T251I
P587L2
Presented with feeding difficulties and hypotonia, At 4.5 months of age the patient contracted an influenza A infection. Concurrently she experienced hepatomegaly associated with severe hypoglycemia, Abnormalities in liver synthetic function, elevations in liver hepatocellular enzymes, elevated cerebrospinal fluid (CSF) protein, severely reduced mtDNA (3%) in liver. liver failure. She showed signs of ongoing respiratory difficulty, pancreatitis, and renal tubulopathy
-liver failure
-hypotonic
-pancreatitis
-hepatomegaly
-hypoglycemia
-renal tubulopathy
infantile
0.1660.4160.458Lutz et al, 2009;

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330C418R1
A467T2
presented in status epilepticus, with a 24 h history of lethargy and vomiting, ataxia diagnosed at 17 months, diffuse encephalopathy,
-status epilepticus
-movement disorder (ataxia)
-encephalopathy
-vomiting
infantile
1.42n/a3.58McCoy et al, 2011;

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329R852C1
A467T2
clonic seizures of the right arm and leg, Coma persisted and was accompanied by hypoglycaemia, tachycardia and oliguria, CSF proteinwas elevated, cortical blindness, anarthria and profound hypotonia, Liver dysfunction, prolonged focal seizures, acute encephalopathy,
-focal seizures
-liver dysfunction
-hypotonic
-encephalopathy
-cortical blindness
infantile
1.75n/a3.5McCoy et al, 2011;

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318G848S1
A467T2
Myoclonic Seizures, Epilepsia partialis continua, Developmental Delay or Regression, ataxia, Abnormal Liver Enzymes, Serum Lactate, liver mtDNA depletion, Alpers
-myoclonic seizures
-epilepsia partialis
-movement disorder (ataxia)
-developmental delay
-Alpers syndrome
-encephalopathy
infantile
0.5n/a3.33Hunter et al, 2011;

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319G848S1
A467T2
Myoclonic Seizures, Generalized tonic-clonic seizures, Focal motor seizures, Developmental Delay or Regression, hypotonia, tremor, Abnormal Liver Enzymes, Serum Lactate, liver mtDNA depletion, death by liver failure, Alpers
-myoclonic seizures
-liver failure
-hypotonic
-developmental delay
-Alpers syndrome
-tremor
-encephalopathy
-epilepsy
infantile
0.83n/a0.92Hunter et al, 2011;

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321R852C1
A467T2
Myoclonic Seizures, visual disturbance, motor paresis, Focal motor seizures, Epilepsia partialis continua, Developmental Delay or Regression, ataxia, Serum Lactate, liver mtDNA depletion, Alpers
-myoclonic seizures
-epilepsia partialis
-movement disorder (ataxia)
-developmental delay
-Alpers syndrome
-encephalopathy
infantile
1.33n/a5.08Hunter et al, 2011;

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323L966R1
A467T2
Generalized tonic-clonic seizures, Focal motor seizures, Epilepsia partialis continua, Developmental Delay or Regression, visual disturbance, Abnormal Liver Enzymes, liver mtDNA depletion, Alpers
-epilepsia partialis
-developmental delay
-Alpers syndrome
-encephalopathy
infantile
0.75n/a1.75Hunter et al, 2011;

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324L966R1
A467T2
Focal motor seizures, Epilepsia partialis continua, Developmental Delay or Regression, motor paresis, tremor Abnormal Liver Enzymes, Alpers
-epilepsia partialis
-developmental delay
-Alpers syndrome
-tremor
-encephalopathy
infantile
1.42n/a1.58Hunter et al, 2011;

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327L966R1
A467T2
focal seizures, elevated blood lactate, elevated liver enzymes, Elevated CSF protein, severe lactic acidosis, severe encephalopathy, Death occurred ten days after admission
-lactic acidosis
-focal seizures
-encephalopathy
infantile
1.42n/a1.42McCoy et al, 2011;

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328G848S1
A467T2
focal seizures, elevated liver transaminases, Elevated CSF protein, patient died several weeks later
-focal seizures
infantile
0.8n/a1McCoy et al, 2011;

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80G11D
R852C1
A467T2
Alpers, seizures, abnormal liver function, mild lactic acidosis, normal histology of COX fibers.
-lactic acidosis
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
1.25n/an/aStewart et al, 2009;

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704A957P1
A467T2
mild motor retardation was first noted at 6 months. At the age of 16 months, he was admitted to a local hospital for status epilepticus. At 18 months, generalized brain atrophy. epilepsia partialis continua, which was partially controlled by carbamazepine, later switched to oxcarbazepine. Elevated blood lactate. Alpers. He died at 2 years of age after severe complications from liver failure.
-status epilepticus
-epilepsia partialis
-liver failure
-retardation
-Alpers syndrome
-encephalopathy
-developmental delay
infantile
0.5n/a2Ferrari et al, 2005;

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521G848S1
A467T2
Alpers, Epilepsy, developmental delay, COX deficient fibres.
-epilepsy
-developmental delay
-Alpers syndrome
-encephalopathy
infantile
1n/an/aStewart et al, 2009;

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702G848S1
A467T2
He developed normally in the first 6 months. Refusal of food and failure to thrive were noted from the 7th month of life. At 1 year of age, increased transaminase levels in the blood were accompanied by liver enlargement and hyperecogenicity. Motor development was delayed. hypoglycaemic episodes and lactic acidosis. A liver biopsy at the age of 16 months revealed steatosis and fibrosis. At 20 months of age, he had numerous episodes of status epilepticus and epilepsia partialis continua. The patient died at 2.5 years of age during an episode of status epilepticus. Alpers’ syndrome.
-lactic acidosis
-status epilepticus
-epilepsia partialis
-failure to thrive
-Alpers syndrome
-encephalopathy
-developmental delay
infantile
0.5n/a2.5Ferrari et al, 2005;

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689G848S1
A467T2
Hepatopathy, Epilepsy, Hepatopathy,
-epilepsy
infantile
1.5n/an/aAshley et al, 2008;

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470G848S1
A467T2
Epilepsy, stroke-like episodes.
-epilepsy
-stroke
-stroke-like episodes
infantile
0.6n/a0.6Tzoulis et al, 2013;

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639G848S1
T251I
P587L2
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
0.5n/an/aWong et al, 2008;

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29K1191R1
T251I
P587L2
Developmental delay/dementia, liver dysfunction, lactic acidosis, fatigue, pancreatitis, cyclic vomiting.
-lactic acidosis
-liver dysfunction
-developmental delay
-dementia
-vomiting
-cyclic vomiting
-pancreatitis
infantile
1n/an/aWong et al, 2008;

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638T914P1
A467T2
Developmental delay, dementia, seizures, Alpers
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
2n/an/aWong et al, 2008;

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31E1136K1
T251I
P587L2
Vomiting, FTT, hypotonic, lactic acidemia, hypoglycemia, bilateral dense cataracts, hepatomegaly, jaundice, septicemia. infantile hepatocerebral mtDNA depletion. Mother with E1136K allele reported as asymptomatic. Father with T251I/P587L allele reported as asymptomatic.
-lactic acidosis
-hepatocerebral
-jaundice
-failure to thrive
-hypotonic
-vomiting
-hepatomegaly
-hypoglycemia
-septicemia
infantile
0.01n/a0.5Taanman et al, 2009;

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447G848S1
A467T2
Alpers, status epilepticus and somnolence, ataxia with dysmetria and muscular hypotonia. Healthy unrelated parents. Laboratory investigations revealed myoclonic epilepsy with ragged red fibers,
-status epilepticus
-epilepsy
-movement disorder (ataxia)
-ragged red fibers
-hypotonic
-Alpers syndrome
-encephalopathy
-developmental delay
infantile
2.23.55.5Hasselmann et al, 2010;

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49R853Q1
T251I
P587L2
Developmental delay, dementia, lactic acidosis, microcephaly, FTT, hearing loss, abnormal MRI.
-lactic acidosis
-failure to thrive
-developmental delay
-dementia
-microcephaly
-hearing loss
infantile
n/a0.2n/aWong et al, 2008;

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72A467T2
R417T1
onset at 2 years with encephalopathy no hepatopathy.
-encephalopathy
infantile
2n/an/aAshley et al, 2008;

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445T914P1
A467T2
myoclonic status epilepticus, myoclonic seizures at 8 months, developmental regression, febrile upper respiratory tract infection, nearly continuous myoclonic jerks, normocephalic, nondysmorphic, diffuse hypotonia, died secondary to complications of hepatic failure.
-status epilepticus
-myoclonic seizures
-liver failure
-hypotonic
infantile
0.8n/a1Dhamija et al, 2011;

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75A467T2
L428P1
Alpers, cerebellar ataxia at age 2, seizures at age 3, RC deficiency in liver, hepatocellular insufficiency after valproate treatment at age 3.6, death at age 3.8. 8% mtDNA copy number in liver.
-cerebellar ataxia
-movement disorder (ataxia)
-liver dysfunction
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
2n/a3.8Sarzi et al, 2007;

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96L886P1
A467T2
Onset 1 years with dementia, seizures, and liver failure. Alpers
-liver failure
-dementia
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
11n/aWong et al, 2008;

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97T914P1
A467T2
Developmental delay, hypotonia, seizures, myoclonic seizures, hemiparesis, intractable seizure, elevated transaminases, FTT, lactic acidosis, high CSF lactate, elevated pyruvate, high CSF protein, dementia/encephalopathy. 112% mtDNA copy number in muscle, 63% mtDNA copy number in blood.
-lactic acidosis
-myoclonic seizures
-hemiparesis
-intractable seizure
-failure to thrive
-hypotonic
-encephalopathy
-developmental delay
-dementia
infantile
n/a0.9n/aTang et al, 2011;

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98T914P1
A467T2
Onset 2 years with dementia, seizures, and liver failure. Alpers
-liver failure
-dementia
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
2n/an/aWong et al, 2008;

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99T914P1
A467T2
Onset at 9 months with alpers, death at 12 months. 8% mtDNA copy number in liver, 8% mtDNA copy number in muscle.
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
0.8n/a1Taanman et al, 2009;

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100T914P1
A467T2
Developmental delay, seizures, myoclonic seizures, intractable seizure, respiratory deficiency/failure, abnormal EEG, abnormal MRI. 60% mtDNA copy number in blood.
-myoclonic seizures
-intractable seizure
-developmental delay
-respiratory deficiency
infantile
n/a0.8n/aTang et al, 2011;

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102T914P1
A467T2
Seizures, hepatic failure, duplicated cyst of ileum, FTT, diarrhea. 13% mtDNA copy number in liver.
-liver failure
-failure to thrive
-diarrhea
infantile
n/a4n/aTang et al, 2011;

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529G848S1
A467T2
mtDNA depletion. severe hypoglycemia, liver biopsy shows micronodular cirrhosis. At 3 y 9 m, status epilepticus develops which occurs again at 4 y and is difficult to control. myoclonia. She dies from bronchopulmonary infection when 5 y old. COX negative fibers.
-status epilepticus
-hypoglycemia
infantile
0.2545Roels et al, 2009;

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105T914P1
A467T2
Onset at 1.5 years with encephalopathy and hepatopathy and cortical blindness. Diagnosed as Alpers.
-encephalopathy
-cortical blindness
-Alpers syndrome
-developmental delay
-epilepsy
infantile
1.52n/aHorvath et al, 2006;

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408G848S1
A467T2
Delayed motor and mental development, From the age of 3 years his psychomotor development declined and epilepsy, visual impairment and sensorineuronal deafness, epilepsia partialis continua. Bilateral ptosis, generalized hypotonia, ataxia, absent reflexes and hyperlaxity by age 5.
-epilepsy
-epilepsia partialis
-movement disorder (ataxia)
-ptosis
-hypotonic
infantile
35n/ade Vries et al, 2008;

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108K1191N1
A467T2
Onset at .5 years with encephalopathy, liver dysfunction, cardiopathy, diagnosed as Alpers, death at 1.3 years.
-liver dysfunction
-encephalopathy
-cardiopathy
-Alpers syndrome
-developmental delay
-epilepsy
infantile
0.5n/a1.3Horvath et al, 2006;

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109R852C1
G11D
A467T2
Seizures, myoclonic seizures, intractable seizures, hepatic failure, elevated transaminases, Apnes/Hypoventilation, respiratory deficiency/failure, lactic acidosis, organic aciduria/tiglyglycine, low plasma carnitine, abnormal EEG. 108% mtDNA copy number in blood.
-lactic acidosis
-myoclonic seizures
-intractable seizure
-liver failure
-respiratory deficiency
infantile
n/a0.8n/aTang et al, 2011;

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632G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, Stroke, ataxia, exercise intolerance
-movement disorder (ataxia)
-exercise intolerance
-stroke
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
childhood
9n/an/aWong et al, 2008;

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422D1184N1
T251I
P587L2
Peripheral neuropathy, PEO, fatty liver
-peripheral neuropathy
-PEO
childhood
9n/a30Amiot et al, 2009;

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421D1184N1
T251I
P587L2
Peripheral neuropathy, PEO, ataxia, epilepsy, fatty liver
-epilepsy
-movement disorder (ataxia)
-peripheral neuropathy
-PEO
childhood
9n/a33Amiot et al, 2009;

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351T851A1
N468D2
CPEO, neuropathy, ataxia, hepatopathy, dysphagia/ dysarthria, gastrointestinal symptoms, severe diarrhoea alternating with constipation,
-movement disorder (ataxia)
-PEO
-dysphagia
-dysarthria
childhood
n/a49n/aWoodbridge et al, 2012;

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536S1104F1
A467T2
Epilepsy, Ataxia, Myopathy.
-epilepsy
-movement disorder (ataxia)
-myopathy
childhood
n/a5n/aSitarz et al, 2014;

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311G848S1
A467T2
Cyclic vomiting, episodic hypoglycemia then seizure onset at 6 years, generalized seizures, GI dysmotility, eyelid ptosis,ophthalmoplegia, sensorineural hearning loss, absent smooth pursuit eye movements
-ptosis
-ophthalmoplegia
-GI dysmotility
-vomiting
-cyclic vomiting
-hypoglycemia
childhood
611n/aSaneto et al, 2010;

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107C1188R1
A467T2
Developmental delay, seizures, abnormal MRI, hypotonia, low in blood.
-hypotonic
-developmental delay
childhood
n/a3n/aTang et al, 2011;

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106L966R1
A467T2
Reported as Alpers, onset at 4 years, presenting encephalopathy with epilepsy.
-epilepsy
-encephalopathy
-Alpers syndrome
-developmental delay
childhood
4n/an/aAshley et al, 2008;

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104T914P1
A467T2
Onset at 4 years with encephalopathy, myoclonus, and SLE.
-myoclonic seizures
-encephalopathy
childhood
48n/aHorvath et al, 2006;

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103T914P1
A467T2
Developmental delay, headaches/migraines, seizures, hemiparesis, intractable seizure, high CSF lactate, high CSF protein, hearing loss, abnormal EEG, increased signal basal ganglia, abnormal MRI. 88% mtDNA copy number in blood.
-hemiparesis
-intractable seizure
-headache/ migraine
-developmental delay
-hearing loss
childhood
n/a5n/aTang et al, 2011;

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101T914P1
A467T2
Developmental delay, hypotonia, dementia/encephalopathy, seizures, intractable seizure, lactic acidosis, high CSF lactate, abnormal MRI, no liver problem at 3.5 years. 24% mtDNA copy number in blood.
-lactic acidosis
-intractable seizure
-hypotonic
-encephalopathy
-developmental delay
-dementia
childhood
n/a3n/aTang et al, 2011;

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73A467T2
C418R1
Onset at 3 years of age, encephalopathy presenting with epilepsy and movement disorder (ataxia).
-epilepsy
-movement disorder (ataxia)
-encephalopathy
childhood
3n/an/aAshley et al, 2008;

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48N1157S1
T251I
P587L2
N/A (as reported in Tang 2011 JMG)
-no known symptoms
childhood
n/a9n/aTang et al, 2011;

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688T914P1
A467T2
Hepatopathy
-no known symptoms
juvenile
15n/an/aAshley et al, 2008;

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24N864S1
T251I
P587L2
MNGIE-like, presented with GI symptoms, ptosis, neuropathy, muscle weakness.
-muscle weakness
-ptosis
juvenile
15n/an/aVan Goethem et al, 2003c;

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604G848S1
T251I
P587L2
PEO. cytochrome c oxidase negative ragged red fibers, and multiple mtDNA deletions in skeletal muscle.
-ragged red fibers
-cox-negative
-PEO
adult
n/an/an/aLamantea et al, 2002;

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9A467T2
A143V1
Dementia/encephalopathy, headaches/migraines, ataxia, seizures, peripheral neuropathy, exercise intolerance, muscle weakness, easy fatigability, CPEO, abnormal EMG/NCV, hearing loss, cerebellar atrophy, abnormal MRI. 82% mtDNA copy number in blood.
-movement disorder (ataxia)
-cerebellar atrophy
-peripheral neuropathy
-muscle weakness
-exercise intolerance
-PEO
-headache/ migraine
-encephalopathy
-dementia
-hearing loss
adult
n/a49n/aTang et al, 2011;

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524G517V2
Y955C1
Peripheral neuropathy, myopathy, ptosis, CPEO, COX deficiency, ragged red fibres
-peripheral neuropathy
-ragged red fibers
-myopathy
-ptosis
-PEO
adult
n/a47n/aTang et al, 2011;

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503R869Q1
P587L2
T251I
Pareses, ptosis, ataxia, sensory neoropathy, motor neuropathy, axonal neuropathy, demyelinating neuropathy.
-movement disorder (ataxia)
-demyelinating neuropathy
-ptosis
adult
2934n/aHanisch et al, 2014;

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227A467T2
S1104C1
PEO, bilateral ptosis, severe limita- tion of ocular motility, and a mosaic distribution of ragged-red and cytochrome c oxidase–negative fibers in the muscle biopsy. All patients had multiple deletions of muscle mtDNA.
-ragged red fibers
-ptosis
-PEO
adult
48n/an/aAgostino et al, 2003;

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4A467T2
F88L1
Clinical indications reported as N/A only information provided is age of patient and 71% mtDNA copy number in blood.
-no known symptoms
adult
n/a42n/aTang et al, 2011;

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25H932Y1
T251I
P587L2
Peripheral neuropathy, exercise intolerance, muscle cramps after exercise, easy fatigability, arrythmia, CPEO, abnormal EMG/NCV, ptosis, cataract, abnormal muscle histology, abnormal muscle ultrastructure, COX deficiency, ragged red fibers. 123% mtDNA copy number in blood.
-peripheral neuropathy
-abnormal muscle histology
-abnormal muscle ultrastructure
-ragged red fibers
-exercise intolerance
-ptosis
-PEO
adult
n/a31n/aTang et al, 2011;

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26H932Y1
T251I
P587L2
Peripheral neuropathy, ptosis, muscle weakness, CPK abnormalities. 77% mtDNA copy number in blood.
-peripheral neuropathy
-muscle weakness
-ptosis
-CPK abnormalities
adult
n/a41n/aTang et al, 2011;

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27G848S1
T251I
P587L2
Ocular bulbar weakness, peripheral neuropathy, muscle weakness, CPEO, ptosis, hypothyroidism, abnormal muscle histology, abnormal muscle ultrastructure, large mitochondrial proliferation, ragged red fibers. 96% mtDNA copy number in blood. Patient II-44.
-peripheral neuropathy
-abnormal muscle histology
-abnormal muscle ultrastructure
-ragged red fibers
-muscle weakness
-ptosis
-PEO
-ocular bulbar weakness
-hypothyroidism
adult
n/a81n/aTang et al, 2011;

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28K1191N1
T251I
P587L2
Stroke/ischaemic episodes, peripheral neuropathy, CPEO, abnormal EMG/NCV, ptosis, muscle weakness, headache/migraine. 167% mtDNA copy number in blood.
-peripheral neuropathy
-muscle weakness
-ptosis
-PEO
-stroke
-headache/ migraine
-ischaemic episodes
adult
n/a39n/aTang et al, 2011;

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30V1106I1
T251I
P587L2
PEO with myopathy
-myopathy
-PEO
adult
n/a35n/aHorvath et al, 2006;

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128R1138C1
A467T2
Onset 48 years with neuropathy, myopathy, SANDO, lactic acidosis PEO.
-lactic acidosis
-myopathy
-PEO
adult
48n/an/aWong et al, 2008;

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131D1184N1
N468D2
PEO and tetraparesis, serum CK level elevated.
-PEO
adult
32n/an/aGonzalez-Vioque et al, 2006;

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136A889T1
R579W2
Onset at age 30 with ptosis, later development of ataxia orthostatic dizziness, cataracts, GI dysmotility with diarrhea and constipation.
-movement disorder (ataxia)
-ptosis
-GI dysmotility
-diarrhea
adult
30n/an/aFilosto et al, 2003;

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484N468D2
A1105T1
Resting tremor, rigidity, bradykinesia, ptosis, PEO, general fatigue, muscle weakness, periodic depression, parkinsons, premature menopause.
-muscle weakness
-ptosis
-PEO
-parkinson's disease
-tremor
adult
3250n/aLuoma et al, 2004;

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250G848S1
T251I
P587L2
PEO, severe ophthalmoplegia and ptosis, which appeared insidiously and had been present clinically since the age of 55. Muscle biopsy at age 68 revealed mitochondrial myopathy, as well as muscle inflammation with granulomas. multiple mtDNA deletions in muscle tissue.
-myopathy
-mitochondrial myopathy
-ptosis
-PEO
-ophthalmoplegia
adult
5575n/aKollberg et al, 2005;

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276R1138C1
A467T2
Bilateral ptosis, distal lower limbs paresthesias, dysphagia, imbalance, inattention, ophthalmoparesis, Multiple mtDNA deletions detected by PCR in blood and muscle
-ptosis
-PEO
-dysphagia
adult
4654n/aMilone et al, 2011;

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313G848S1
T251I
P587L2
progressively droopy eyelids, double vision, gait instability, proximal arm weakness, ragged red and ragged blue (succinate dehydrogenase–positive) fibers in about 3% and 6% of all muscle fibers, bilateral ptosis, diplopia, dysarthria, myopathy involving the facial muscles, sensory ataxic polyneuropathy
-polyneuropathy
-ragged red fibers
-myopathy
-ptosis
-diplopia
-dysarthria
adult
n/a80n/aWeiss and Saneto, 2010;

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419M919T1
A467T2
Peripheral neuropathy, PEO, ataxia
-movement disorder (ataxia)
-peripheral neuropathy
-PEO
adult
2341n/aAmiot et al, 2009;

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482N468D2
A1105T1
Ptosis, PEO, Cataracts, sensory axonal neuropathy, moderate motor neuropathy, rigidity, bradykinesia, resting tremor, Parkinsons, muscle weakness.
-demyelinating neuropathy
-muscle weakness
-ptosis
-PEO
-parkinson's disease
-tremor
adult
304951Luoma et al, 2004;

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483N468D2
A1105T1
Resting tremor, rigidity, bradykinesia, ptosis, PEO, Excercise intolerance, muscle pain, sensory axonal neuropathy, Parkinsons
-demyelinating neuropathy
-ptosis
-PEO
-parkinson's disease
-tremor
adult
2140n/aLuoma et al, 2004;

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264R852C1
A467T2
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
unknown
n/an/an/aNguyen et al, 2006;

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265T914P1
A467T2
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
unknown
n/an/an/aNguyen et al, 2006;

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266L966R1
A467T2
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
unknown
n/an/an/aNguyen et al, 2006;

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1-5 pathogenic cluster assignment of mutations. Mutations displayed without a superscript number are outside of the assigned pathogenic clusters. See cluster definitions for details.

Number of displayed patient cases: 96
Avg age of onset in displayed cases: 11.4
Std dev in onset in displayed cases: 18.5

Search criteria for patient entries:
Mutations Entry IDs Clusters Reference Residue range
Patients for cluster combinations:
First cluster: Second cluster:
Age group: Any Infantile Childhood Juvenile Adult
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