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From the John F. Kennedy Institute, (Drs. Østergaard, Wibrand, and Horn), Glostrup, Denmark; and the Department of Neurology and the Copenhagen Muscle Research Center (Drs. Ørngreen and Vissing), National University Hospital, Rigshospitalet, Copenhagen, Denmark.
Address correspondence and reprint requests to Dr. Elsebet Østergaard, John F. Kennedy Institute, Gl. Landevej 7, 2600 Glostrup, Denmark; e-mail: els{at}kennedy.dk
The authors report a 27-year-old man with B12-responsive muf- methylmalonic aciduria associated with pure muscle symptoms. Two mutations were found in the methylmalonyl-CoA mutase gene. An exercise test showed a reduced maximal workload and reduced oxygen uptake, and a muscle biopsy showed subsarcolemmal accumulation of mitochondria and normal respiratory chain enzyme activities. These findings may be caused by inhibition of mitochondrial energy metabolism by methylmalonate or its metabolites.
Disclosure: The authors report no conflicts of interest.
Received August 26, 2004. Accepted in final form June 7, 2005.
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