2.1. Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes

Mutations in the MT-TV gene are a very rare cause of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS). Most cases of MELAS are caused by mutations in other mitochondrial genes, but a small number of cases resulting from mutations in the MT-TV gene have been reported. At least two mutations have been identified, each of which alters a single DNA building block (nucleotide) in the gene. One of these mutations replaces the nucleotide guanine with the nucleotide adenine at gene position 1642 (written as G1642A). Another mutation changes the nucleotide guanine to the nucleotide adenine at position 1644 (G1644A). Changes in the MT-TV gene may reduce the amount of tRNA^Val available to assemble proteins within mitochondria. Because these proteins are needed for oxidative phosphorylation, MT-TV mutations may impair the ability of mitochondria to produce energy. Researchers have not determined how changes in mitochondrial energy production can lead to the specific features of MELAS.

2.2. Other disorders

A few other mutations in the MT-TV gene have been have been reported, most of which change single nucleotides in the gene. These mutations are responsible for a variety of signs and symptoms chiefly affecting the muscles and nervous system. Medical problems associated with MT-TV mutations have included recurrent migraine headaches, muscle weakness and problems with movement, poor coordination, seizures, hearing loss, learning disabilities, and loss of intellectual function (dementia). A heart condition called cardiomyopathy, which weakens and enlarges the heart muscle, also has been reported in a small number of affected individuals.

Changes in the MT-TV gene have been identified as a rare cause of Leigh syndrome, a progressive brain disorder that typically appears in infancy or early childhood. In a few cases, MT-TV mutations were found in people with signs and symptoms that did not appear until adulthood. Affected individuals may experience vomiting, seizures, delayed development, muscle weakness, and problems with movement. Heart disease, kidney problems, and difficulty breathing can also occur in people with this disorder.

It is unclear why changes in the MT-TV gene can cause such a large variety of signs and symptoms. Even within a single family, affected individuals may have different health problems caused by the same genetic change.