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Genetics Home Reference: your guide to understanding genetic conditions
http://ghr.nlm.nih.gov/     A service of the U.S. National Library of Medicine®

Childhood myocerebrohepatopathy spectrum

(often shortened to MCHS)
Reviewed June 2011

What is MCHS?

Childhood myocerebrohepatopathy spectrum, commonly called MCHS, is part of a group of conditions called the POLG-related disorders. The conditions in this group feature a range of similar signs and symptoms involving muscle-, nerve-, and brain-related functions. MCHS typically becomes apparent in children from a few months to 3 years old. People with this condition usually have problems with their muscles (myo-), brain (cerebro-), and liver (hepato-).

Common signs and symptoms of MCHS include muscle weakness (myopathy), developmental delay or a deterioration of intellectual function, and liver disease. Another possible sign of this condition is a toxic buildup of lactic acid in the body (lactic acidosis). Often, affected children are unable to gain weight and grow at the expected rate (failure to thrive).

Additional signs and symptoms of MCHS can include a form of kidney disease called renal tubular acidosis, inflammation of the pancreas (pancreatitis), recurrent episodes of nausea and vomiting (cyclic vomiting), or hearing loss.

How common is MCHS?

The prevalence of childhood myocerebrohepatopathy spectrum is unknown.

What genes are related to MCHS?

MCHS is caused by mutations in the POLG gene. This gene provides instructions for making one part, the alpha subunit, of a protein called polymerase gamma (pol γ). Pol γ functions in mitochondria, which are structures within cells that use oxygen to convert the energy from food into a form cells can use. Mitochondria each contain a small amount of DNA, known as mitochondrial DNA (mtDNA), which is essential for the normal function of these structures. Pol γ "reads" sequences of mtDNA and uses them as templates to produce new copies of mtDNA in a process called DNA replication.

Most POLG gene mutations change single protein building blocks (amino acids) in the alpha subunit of pol γ. These changes result in a mutated pol γ that has a reduced ability to replicate DNA. Although the mechanism is unknown, mutations in the POLG gene often result in fewer copies of mtDNA (mtDNA depletion), particularly in muscle, brain, or liver cells. MtDNA depletion causes a decrease in cellular energy, which could account for the signs and symptoms of MCHS.

Related Gene(s)

Changes in this gene are associated with childhood myocerebrohepatopathy spectrum.

  • POLG

How do people inherit MCHS?

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Where can I find information about diagnosis or management of MCHS?

These resources address the diagnosis or management of MCHS and may include treatment providers.

  • Gene Review: POLG-Related Disorders (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=alpers)
  • United Mitochondrial Disease Foundation: Diagnosis of Mitochondrial Disease (http://www.umdf.org/site/c.otJVJ7MMIqE/b.5692885/k.E71C/Getting_a_Diagnosis.htm)

You might also find information on the diagnosis or management of MCHS in Educational resources (http://www.ghr.nlm.nih.gov/condition/childhood-myocerebrohepatopathy-spectrum/show/Educational+resources) and Patient support (http://www.ghr.nlm.nih.gov/condition/childhood-myocerebrohepatopathy-spectrum/show/Patient+support).

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook.

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about MCHS?

You may find the following resources about MCHS helpful. These materials are written for the general public.

  • MedlinePlus - Health information

    • Encyclopedia: Lactic Acidosis (http://www.nlm.nih.gov/medlineplus/ency/article/000391.htm)
    • Health Topic: Genetic Brain Disorders (http://www.nlm.nih.gov/medlineplus/geneticbraindisorders.html)
    • Health Topic: Liver Diseases (http://www.nlm.nih.gov/medlineplus/liverdiseases.html)
  • Additional NIH Resources - National Institutes of Health
    National Institutes of Health Rare Diseases Clinical Research Network: North American Mitochondrial Disease Consortium (http://rarediseasesnetwork.epi.usf.edu/NAMDC/index.htm)

  • Educational resources - Information pages

    • Cleveland Clinic: Mitochondrial Diseases (http://my.clevelandclinic.org/disorders/mitochondrial_disease/hic_myths_and_facts_about_mitochondrial_diseases.aspx)
    • Cleveland Clinic Online Health Chats: Understanding Mitochondrial Disorders (http://my.clevelandclinic.org/multimedia/transcripts/parikh_understanding_mitochondrial_disorders.aspx)
    • Family Village: Mitochondrial Disorders (http://www.familyvillage.wisc.edu/lib_mito.htm)
    • Mayo Clinic: Mitochondrial Disease Biobank (http://mayoresearch.mayo.edu/mitochondrial-disease-biobank/)

  • Patient support - For patients and families

    • American Liver Foundation: The Progression of Liver Disease (http://www.liverfoundation.org/abouttheliver/info/progression/)
    • MitoAction (http://www.mitoaction.org/)
    • Muscular Dystrophy Association: Mitochondrial Myopathies (http://mda.org/disease/mitochondrial-myopathies)
    • United Mitochondrial Disease Foundation: Mitochondrial Disease (http://www.umdf.org/site/c.otJVJ7MMIqE/b.5692879/k.3851/What_is_Mitochondrial_Disease.htm)

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

  • Gene Reviews - Clinical summary (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=alpers)

  • Genetic Testing Registry - Repository of genetic test information

    • Genetic Testing Registry: Progressive sclerosing poliodystrophy (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0205710)
  • ClinicalTrials.gov - Linking patients to medical research (http://clinicaltrials.gov/ct2/results?cond=%22childhood%20myocerebrohepatopathy%20spectrum%22%20OR%20%22Mitochondrial%20Diseases%22)
  • PubMed - Recent literature (http://www.ncbi.nlm.nih.gov/pubmed?term=((POLG%5BTIAB%5D)%20AND%20(mtDNA%20depletion%5BTIAB%5D))%20AND%20english%5Bla%5D%20AND%20human%5Bmh%5D%20AND%20%22last%203600%20days%22%5Bdp%5D)

What if I still have specific questions about MCHS?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).

What glossary definitions help with understanding MCHS?

acidosis ; acids ; autosomal ; autosomal recessive ; cell ; depletion ; developmental delay ; DNA ; DNA replication ; failure to thrive ; gene ; inflammation ; kidney ; lactic acid ; lactic acidosis ; mitochondria ; oxygen ; pancreas ; pancreatitis ; prevalence ; protein ; recessive ; renal ; sign ; spectrum ; subunit ; toxic

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://www.ghr.nlm.nih.gov/glossary).

References

  • Gene Review: POLG-Related Disorders (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=alpers)
  • Milone M, Massie R. Polymerase gamma 1 mutations: clinical correlations. Neurologist. 2010 Mar;16(2):84-91. doi: 10.1097/NRL.0b013e3181c78a89. Review. (http://www.ncbi.nlm.nih.gov/pubmed/20220442?dopt=Abstract)
  • Moraes CT, Shanske S, Tritschler HJ, Aprille JR, Andreetta F, Bonilla E, Schon EA, DiMauro S. mtDNA depletion with variable tissue expression: a novel genetic abnormality in mitochondrial diseases. Am J Hum Genet. 1991 Mar;48(3):492-501. (http://www.ncbi.nlm.nih.gov/pubmed/1998336?dopt=Abstract)
  • Rocher C, Taanman JW, Pierron D, Faustin B, Benard G, Rossignol R, Malgat M, Pedespan L, Letellier T. Influence of mitochondrial DNA level on cellular energy metabolism: implications for mitochondrial diseases. J Bioenerg Biomembr. 2008 Apr;40(2):59-67. doi: 10.1007/s10863-008-9130-5. Epub 2008 Apr 16. (http://www.ncbi.nlm.nih.gov/pubmed/18415670?dopt=Abstract)
  • Stumpf JD, Copeland WC. Mitochondrial DNA replication and disease: insights from DNA polymerase γ mutations. Cell Mol Life Sci. 2011 Jan;68(2):219-33. doi: 10.1007/s00018-010-0530-4. Epub 2010 Oct 8. Review. (http://www.ncbi.nlm.nih.gov/pubmed/20927567?dopt=Abstract)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: June 2011
Published: May 13, 2013