Cause of Death in Children With Mitochondrial Diseases

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• 作者：Soyong Eom ; MD ; PhD^a ; Ha Neul Lee ; MD^b ; Sunho Lee ; MD^b ; Hoon-Chul Kang ; MD ; PhD^c ; Joon Soo Lee ; MD ; PhD^c ; Heung Dong Kim ; MD ; PhD^c ; Young-Mock Lee ; MD ; PhD^b ; ^{ymleemd@yuhs.ac}
• 关键词：mitochondrial disease ; pediatric ; children ; cause of death ; risk factor ; mortality
• 刊名：Pediatric Neurology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：66
• 期：Complete
• 页码：82-88
• 全文大小：419 K
• 卷排序：66

文摘

We investigated the clinical characteristics that represent risk factors for death in pediatric patients with mitochondrial diseases.MethodsThe medical records of mitochondrial disease pediatric patients attended between 2006 and 2015 (n = 221) were reviewed for clinical characteristics, diagnosis, hospitalization, follow-up, survival, and cause of death.ResultsThe global mortality rate in the cohort was 14% (average age at death, six years). By syndromic diagnosis, the mortality rates were as follows: Leigh syndrome, 17% (15 of 88); mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes, 50% (two of four); and nonspecific mitochondrial disease, 11% (14 of 129). Data regarding 31 patients (17 males) were included in the analysis of cause of death. The age at symptom onset, lead time to diagnosis, duration of illness, and duration of life were 1.8 ± 2.0, 1.7 ± 1.5, 4.3 ± 2.7, and 6.1 ± 2.9 years, respectively. The most common causes of death were sepsis, pneumonia, disseminated intravascular coagulation, and sudden unexpected death (55%, 42%, 29%, and 29%, respectively). Early death (age six years or younger) was associated with lesions in the thalamus, number of organs involved, and Leigh syndrome.ConclusionsCareful monitoring of the medical condition and early intervention are key to improving survival in pediatric patients with mitochondrial disease.