Fulminant Neonatal Liver Failure in MPV 17-Related Mitochondrial DNA Depletion Syndrome

Mitochondrial depletion syndromes are well established causes of liver failure in infants. Hepatocerebral variant related to MPV17 gene defect is characterized by infantile onset of progressive liver failure, developmental delay, neurological manifestations, lactic acidosis, hypoglycemia, and mtDNA...

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Main Authors: Razan Abduljalil, Hadhami Ben Turkia, Aysha Fakhroo, Cristina Skrypnyk
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Case Reports in Hepatology
Online Access:http://dx.doi.org/10.1155/2023/4514552
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author Razan Abduljalil
Hadhami Ben Turkia
Aysha Fakhroo
Cristina Skrypnyk
author_facet Razan Abduljalil
Hadhami Ben Turkia
Aysha Fakhroo
Cristina Skrypnyk
author_sort Razan Abduljalil
collection DOAJ
description Mitochondrial depletion syndromes are well established causes of liver failure in infants. Hepatocerebral variant related to MPV17 gene defect is characterized by infantile onset of progressive liver failure, developmental delay, neurological manifestations, lactic acidosis, hypoglycemia, and mtDNA depletion in liver tissue. We report a hepatocerebral variant of mitochondrial DNA depletion syndrome in a neonate who presented with septic shock picture, hypoglycemia, jaundice, hypotonia, and rotatory nystagmus. Family history was significant for consanguinity and a brother who died at the age of 4 months. Investigations showed mild liver function derangement contrasting with severe coagulopathy, hyperlactatemia, and generalized aminoaciduria. The brain MRI was normal. Next generation sequencing (NGS) panel identified a MPV17 gene missense homozygous pathogenic variant. The infant expired at the age of 2 weeks with refractory ascites. This case illustrates a challenging diagnosis causing liver failure and death in neonatal period. Genetic testing of mitochondrial DNA depletion syndromes should be a part of liver failure workup in addition to other treatable disorders presenting with encephalo-hepatopathy in infancy.
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spelling doaj-art-e903f290101a44138acbd2982ec556452025-08-20T02:21:53ZengWileyCase Reports in Hepatology2090-65952023-01-01202310.1155/2023/4514552Fulminant Neonatal Liver Failure in MPV 17-Related Mitochondrial DNA Depletion SyndromeRazan Abduljalil0Hadhami Ben Turkia1Aysha Fakhroo2Cristina Skrypnyk3Department of PediatricsDepartment of PediatricsDepartment of PediatricsDepartment of Molecular MedicineMitochondrial depletion syndromes are well established causes of liver failure in infants. Hepatocerebral variant related to MPV17 gene defect is characterized by infantile onset of progressive liver failure, developmental delay, neurological manifestations, lactic acidosis, hypoglycemia, and mtDNA depletion in liver tissue. We report a hepatocerebral variant of mitochondrial DNA depletion syndrome in a neonate who presented with septic shock picture, hypoglycemia, jaundice, hypotonia, and rotatory nystagmus. Family history was significant for consanguinity and a brother who died at the age of 4 months. Investigations showed mild liver function derangement contrasting with severe coagulopathy, hyperlactatemia, and generalized aminoaciduria. The brain MRI was normal. Next generation sequencing (NGS) panel identified a MPV17 gene missense homozygous pathogenic variant. The infant expired at the age of 2 weeks with refractory ascites. This case illustrates a challenging diagnosis causing liver failure and death in neonatal period. Genetic testing of mitochondrial DNA depletion syndromes should be a part of liver failure workup in addition to other treatable disorders presenting with encephalo-hepatopathy in infancy.http://dx.doi.org/10.1155/2023/4514552
spellingShingle Razan Abduljalil
Hadhami Ben Turkia
Aysha Fakhroo
Cristina Skrypnyk
Fulminant Neonatal Liver Failure in MPV 17-Related Mitochondrial DNA Depletion Syndrome
Case Reports in Hepatology
title Fulminant Neonatal Liver Failure in MPV 17-Related Mitochondrial DNA Depletion Syndrome
title_full Fulminant Neonatal Liver Failure in MPV 17-Related Mitochondrial DNA Depletion Syndrome
title_fullStr Fulminant Neonatal Liver Failure in MPV 17-Related Mitochondrial DNA Depletion Syndrome
title_full_unstemmed Fulminant Neonatal Liver Failure in MPV 17-Related Mitochondrial DNA Depletion Syndrome
title_short Fulminant Neonatal Liver Failure in MPV 17-Related Mitochondrial DNA Depletion Syndrome
title_sort fulminant neonatal liver failure in mpv 17 related mitochondrial dna depletion syndrome
url http://dx.doi.org/10.1155/2023/4514552
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