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Living with Combined oxidative phosphorylation defect type 26

A rare mitochondrial condition with a wide range, from tiring easily and muscle weakness to developmental delay in infancy.

Understanding Combined oxidative phosphorylation defect type 26

Combined oxidative phosphorylation defect type 26 is a rare mitochondrial disease that affects how cells make energy.

It varies a lot. Some people have trouble exercising, shortness of breath with effort, muscle weakness, stiffness and nerve problems, without learning or heart problems. Others have global developmental delay, slow growth, low muscle tone and stiffness. More severe cases may include thickened heart muscle, optic nerve changes or seizures. It starts in infancy or childhood.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Trouble exercising and shortness of breath with effort
  • Global developmental delay
  • Feeding difficulties and slow weight gain
  • Thickened heart muscle (hypertrophic cardiomyopathy)
  • Kidney filtering problems (renal tubular dysfunction)
  • Difficulty standing

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include genetic specialists.

  3. Consider genetic testing

    Changes in TRMT5 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

  4. Connect with expert centers

    United Mitochondrial Disease Foundation and MitoAction may keep lists of experts for this condition.

Care & treatment

Care team
Genetic specialists (geneticists)
Expert care
Expert lists: United Mitochondrial Disease Foundation, MitoAction
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with United Mitochondrial Disease Foundation and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Should we have genetic testing for the TRMT5 gene?
How often should the heart and kidneys be checked?
What exercise or activity is safe for me or my child?

Quick facts

Symptoms usually startInfant and as a Child
InheritanceAutosomal Recessive, Mitochondrial
GenesTRMT5

Changes in the TRMT5 gene are listed. GARD lists autosomal recessive and mitochondrial inheritance.

GeneticInherited MetabolicMitochondrial

Also known as: combined oxidative phosphorylation deficiency 26; combined oxidative phosphorylation deficiency caused by mutation in trmt5; combined oxidative phosphorylation deficiency type 26; coxpd26; coxpd26 - combined oxidative phosphorylation defect type 26; peripheral neuropathy with variable spasticity, exercise intolerance, and developmental delay

Patient organizations

Source: NIH GARD · Combined oxidative phosphorylation defect type 26GARD ID 17854 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Combined oxidative phosphorylation defect type 26.

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Explore actively recruiting Combined oxidative phosphorylation defect type 26 studies with HealthSpark.

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  • Eligibility is confirmed by the study team

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Powered by HealthSpark, our AI chat helper · Study information from ClinicalTrials.gov · Eligibility is confirmed by the study team.

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