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Getting a Diagnosis

Mitochondrial diseases are difficult to diagnose. Referral to an appropriate research center is critical. If experienced physicians are involved, however, diagnoses can be made through a combination of clinical observations, laboratory evaluation, cerebral imaging, and muscle biopsies. Despite these advances, many cases do not receive a specific diagnosis.

Most hospitals do not have a metabolic laboratory and therefore can run only the most basic tests. However, most hospitals will send specimens to any laboratory in the country. Not all laboratory tests are required for all patients, and your physician may decide that some of these tests are not necessary. In addition, a single blood or urine lab test with normal results does not rule out a mitochondrial disease. This is true for organic acids, lactic acid, carnitine analysis and amino acid analysis. Even muscle biopsies are not 100% accurate.  

Metabolic Screening in Blood and Urine (all patients)

  • Basic chemistries
  • Complete blood count
  • Blood lactate, pyruvate, L:P ratio
  • Quantitative plasma amino acids
  • Liver enzymes & ammonia
  • Creatinine kinase (CPK)
  • Plasma acylcarnitine analysis
  • Quantitative urine organic acids

Characterize Systemic Involvement (all patients)

  • Echocardiogram
  • Ophthalmologic exam
  • Brain MRI
  • Electrocardiogram (EKG)
  • Audiology testing

Metabolic Screening in Spinal Fluid (patients with neurological symptoms)

  • Lactate & pyruvate
  • Quantitative amino acids
  • Routine studies including cell count, glucose and protein measurement

Clinical Neurogenetics Evaluation (patients with developmental delays)

  • Karyotype
  • Child neurology consultation
  • Fragile X test
  • Genetics consultation

Click here for more information regarding diagnosis, tests, and laboratories that perform mitochondrial testing. 

To locate physicians familiar with mitochondrial disorders, and mitochondrial disease centers closest to you, contact the UMDF.