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Living with Combined oxidative phosphorylation deficiency 28

A rare mitochondrial condition with a range from severe newborn illness to episodes of heart and lung trouble and slow muscle weakness.

Understanding Combined oxidative phosphorylation deficiency 28

Combined oxidative phosphorylation deficiency 28 is a rare mitochondrial disease with a wide range of severity.

Some babies have fluid swelling before birth, low muscle tone, a slow heartbeat and breathing failure in the newborn period. Others have episodes of acute heart and lung trouble with severe acid build-up in infancy, and slowly worsening muscle weakness.

Signs & symptoms

GARD lists few symptoms for this condition. These are listed as less common:

  • Low muscle tone
  • Abdominal pain
  • Heart failure
  • Fatigue
  • Muscle weakness that slowly worsens

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 SLC25A26 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 SLC25A26 gene?
How can we prepare for episodes of heart and lung trouble?
Which specialists should be on our care team?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive, Mitochondrial
GenesSLC25A26

Changes in the SLC25A26 gene are listed. GARD lists autosomal recessive and mitochondrial inheritance.

GeneticInherited MetabolicMitochondrial

Also known as: combined oxidative phosphorylation defect type 28; combined oxidative phosphorylation deficiency caused by mutation in slc25a26; combined oxidative phosphorylation deficiency type 28; coxpd28; coxpd28 - combined oxidative phosphorylation defect type 28; neonatal severe cardiopulmonary failure due to mitochondrial methylation defect

Patient organizations

Source: NIH GARD · Combined oxidative phosphorylation deficiency 28GARD ID 17831 · 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 deficiency 28.

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  • Eligibility is confirmed by the study team

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