TY - JOUR T1 - CYtochrome c oxidase deficiency due to a novel sco2 mutation mimics werdnig-hoffmann disease AU - Salviati L, Sacconi S, Rasalan MM, et al Y1 - 2002/05/01 N1 - 10.1001/archneur.59.5.862 JO - Archives of Neurology SP - 862 EP - 865 VL - 59 IS - 5 N2 - Background  Mutations in the SCO2 gene have been associated with fatal cardioencephalomyopathy.Objective  To report a novel SCO2 mutation with prominent spinal cord involvement mimicking spinal muscular atrophy (Werdnig-Hoffmann disease).Patient and Methods  An infant girl presented at birth with generalized weakness, hypotonia, and lactic acidosis. At 1 month of age she developed hypertrophic cardiomyopathy and died of heart failure 1 month later. Neuroradiological studies were unremarkable. Muscle biopsy specimens showed groups of atrophic and hypertrophic fibers, but mutation screening of the SMN gene was negative. Histochemical and biochemical studies of respiratory chain complexes were performed, and the whole coding region of the SCO2 gene was sequenced.Results  Findings from muscle histochemistry studies showed virtually undetectable cytochrome c oxidase activity, but normal succinate dehydrogenase reaction. Biochemical analysis in muscle confirmed a severe isolated cytochrome c oxidase deficiency. Pathologic findings of the brain were unremarkable, but the ventral horns of the spinal cord showed moderate-to-severe loss of motor neurons and astrocytosis. Sequencing of the SCO2 gene showed the common E140K mutation, and a novel 10 base–pair duplication of nucleotides 1302 to 1311, which disrupts the reading frame of the messenger RNA and gives rise to a truncated protein.Conclusion  The SCO2 mutations should be considered in the differential diagnosis of children with spinal muscular atrophy without mutations in the SMN gene. SN - 0003-9942 M3 - doi: 10.1001/archneur.59.5.862 UR - http://dx.doi.org/10.1001/archneur.59.5.862 ER -