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Living with Fatal mitochondrial disease due to combined oxidative phosphorylation defect type 3

An extremely rare mitochondrial disorder of newborns and infants with low muscle tone, high lactic acid, liver problems and brain or heart muscle disease.

Understanding Fatal mitochondrial disease due to combined oxidative phosphorylation defect type 3

Fatal mitochondrial disease due to combined oxidative phosphorylation defect type 3 is an extremely rare disorder of the energy-making parts of cells.

Signs vary but include low muscle tone (hypotonia), high lactic acid (lactic acidosis), and liver problems. Some babies have worsening brain and muscle disease, and others have thickened heart muscle (hypertrophic cardiomyopathy). It is seen in newborns and infants.

Signs & symptoms

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

  • Low muscle tone (hypotonia)
  • Brain disease (encephalopathy)
  • Thickened heart muscle
  • Seizures
  • Breathing difficulty
  • Poor sucking

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 brain and nervous system specialists and genetic specialists.

  3. Consider genetic testing

    Changes in TSFM 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
Brain and nervous system specialists (neurologists); 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 TSFM gene?
Which specialists should be on my child's care team?
What can be done for feeding and breathing support?

Quick facts

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

Changes in the TSFM gene cause it. GARD lists autosomal recessive and mitochondrial inheritance.

GeneticNeurologicalInherited MetabolicMitochondrial

Also known as: combined oxidative phosphorylation deficiency 3; combined oxidative phosphorylation deficiency caused by mutation in tsfm; combined oxidative phosphorylation deficiency type 3; encephalomyopathy, respiratory failure, and lactic acidosis; fatal mitochondrial disease due to coxpd3; tsfm combined oxidative phosphorylation deficiency

Patient organizations

Source: NIH GARD · Fatal mitochondrial disease due to combined oxidative phosphorylation defect type 3GARD ID 17035 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

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