Freeze-fracturing studies of mitochondrial myopathy. A correlated clinical, biochemical and morphological investigation

Schwann cell mitochondrial alterations in peripheral nerves of rabbits treated with 2',3'-dideoxycytidine

2',3'-Dideoxycytidine (ddC) is a nucleoside analogue and reverse-transcriptase inhibitor that is approved for treatment of AIDS patients. A rabbit model of ddC neurotoxicity was developed to help understand the dose-limiting clinical neurotoxicity of ddC. Rabbits with a myelinopathy resulting from treatment with ddC exhibited mitochondrial alterations in Schwann cells of sciatic and tibial nerves and dorsal root ganglia. These changes were initially evident after 16 weeks of oral treatment with 35 mg/kg per day of ddC and were positively correlated with myelin pathology in individual animals. Cup-shaped mitochondria were frequently observed; when these mitochondria occurred in multiple concentric arrays or at various angles to one another, different profiles were formed depending on the plane of section. An increased number of mitochondrial cristae assumed a tubular configuration. It is suggested that the complex aggregations of mitochondria seen in this experiment are an adaptive response to altered mitochondrial function caused by treatment with ddC.

Myoclonus epilepsy associated with ragged-red fibres (mitochondrial abnormalities ): disease entity or a syndrome? Light-and electron-microscopic studies of two cases and review of literature

A report is given of an association of dyssynergia cerebellaris myoclonica associated with Friedreich's ataxia and mitochondrial myopathy in 2 patients. They had suffered from gradually increasing bursts of myoclonus since the wage of 14 and childhood, respectively. The other striking clinical features included generalized convulsions, mental deterioration, intention tremor, ataxia, muscular atrophy and deformity of feet. Muscle biopsies revealed ragged-red fibres in both cases. On electron microscopy these fibres contained subsarcolemnal aggregations of abundant abnormal mitochondria with proliferation of inner membranes or paracrystalline inclusions. One of these patients showed elevated blood lactate and pyruvate with an increased lactate/pyruvate ration, apparently of primary origin. These 2 cases resemble those reported briefly by Tsairis et al. (1974). An association of dyssynergia cerebellaris myoclonica associated with Friedreich's ataxia and mitochondrial myopathy in these 2 patients is unlikely to be coincidental but may represent one nosological entity. This myoclonus epilepsy syndrome associated with ragged-red fibres is compared with other possibly related mitochondrial encephalomyopathies.

Fatal lipid storage myopathy in an infant: case report and autopsy findings

The clinical presentation, muscle biopsy appearances and autopsy findings in a male infant dying at the age of 13 weeks with a lipid storage myopathy are described. The primary metabolic abnormality was not elucidated but was thought not to be carnitine deficiency.