Journal
AMERICAN JOURNAL OF HUMAN GENETICS
Volume 85, Issue 3, Pages 401-407Publisher
CELL PRESS
DOI: 10.1016/j.ajhg.2009.08.004
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Funding
- Hebrew University
- Hadassah Medical Organization
- Israel Science Foundation [1354-2005]
- Israeli Ministry of Health and Association Francaise contre les Myopathies
- Fondation pour la Recherche Medicale
- Agence Nationale de la Recherche Scientifique
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Acute liver failure in infancy accompanied by lactic acidemia was previously shown to result from mtDNA depletion. We report on 13 unrelated infants who presented with acute liver failure and lactic acidemia with normal mtDNA content. Four died during the acute episodes, and the survivors never had a recurrence. The longest follow-up period was 14 years. Using homozygosity mapping, we identified mutations in the TRMU gene, which encodes a mitochondria-specific tRNA-modifying enzyme, tRNA 5-methylaminomethyl-2-thiouridylate methyltransferase. Accordingly, the 2-thiouridylation levels of the mitochondrial tRNAs were markedly reduced. Given that sulfur is a TRMU substrate and its availability is limited during the neonatal period, we propose that there is a window of time whereby patients with TRMU mutations are at increased risk of developing liver failure.
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