Neuropediatrics 2000; 31(3): 114-121
DOI: 10.1055/s-2000-7491
Original Article

Georg Thieme Verlag Stuttgart · New York

A Prognostic Index as Diagnostic Strategy in Children Suspected of Mitochondriocytopathy

M. E. Rubio-Gozalbo1 , R. C. A. Sengers1 , M. J. F. Trijbels1 , W. H. Doesburg2 , M. A. J. Janssen1 , M. A. L. Verbeek2 , M. J. A. Smeitink1
  • 1 Department of Metabolic Diseases1, University Hospital Nijmegen, The Netherlands
  • 2 Department of Epidemiology and Medical Statistics, University Hospital Nijmegen, The Netherlands
Further Information

Publication History

Publication Date:
31 December 2000 (online)

The aim of this study was to assess an optimal screening for paediatric patients suspected of mitochondriocytopathy to justify a muscle biopsy.

Forty-five patients were included. Medical history, physical examination, cardiac and ophthalmologic evaluation, clinical chemical investigations, in vivo function tests, neuroimaging and a skeletal muscle biopsy were performed in all patients. The results of the biochemical muscle studies were compared with the results of the other investigations. First, parameters with a statistical relationship with the result in muscle, normal or deficient, were selected. Secondly, a prognostic index was constructed using these parameters.

Five parameters were selected: age < 4 years, elevated fasting lactate to pyruvate ratio, elevated thrombocyte count, elevated lactate, and elevated alanine. Each parameter was scored 0 (not present) or 1 (present). The chance of a normal biopsy with a given value of this index (sum of the scores) was calculated: logit (Pr) = α + β × index; α: - 0.8167 and β: 0.8331. (Pr: probability of normal biopsy.) The chance of a normal biopsy with an index value of 5 is 0.03, 4 is 0.07, 3 is 0.16, 2 is 0.30, 1 is 0.50 and 0 is 0.69.

This prognostic index is a valuable instrument in deciding whether the suspicion of mitochondriocytopathy is strong enough to merit a muscle biopsy.

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M. E. Rubio-Gozalbo

Nijmegen Center for Mitochondrial Disorders University Children's Hospital Nijmegen

P. O. Box 9101

6500 HB Nijmegen

The Netherlands

Email: E-mail: E.Rubio@ckskg.azn.nl