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Living with Mitochondrial complex IV deficiency, nuclear-type

A genetic condition (cytochrome c oxidase deficiency) that can affect the muscles, heart, brain, and liver, with symptoms from mild to severe.

Understanding Mitochondrial complex IV deficiency, nuclear-type

Mitochondrial complex IV deficiency, nuclear-type, also called cytochrome c oxidase deficiency, is a genetic condition that can affect the muscles, heart, brain, and liver.

Signs usually begin before age 2 but can appear later in mildly affected people. Severity varies, even within the same family. Mild cases may involve only muscle weakness and low muscle tone. More severe cases involve several body systems, such as brain and muscle disease. About a quarter have thickened heart muscle, and some have an enlarged liver. Many people have a group of features known as Leigh syndrome.

Signs & symptoms

GARD doesn't list a set of most common symptoms for this condition. Its summary describes these features:

  • Muscle weakness (myopathy)
  • Low muscle tone (hypotonia)
  • Thickened heart muscle (hypertrophic cardiomyopathy)
  • Enlarged liver (hepatomegaly)
  • Lactic acid buildup in the body
  • Leigh syndrome features, such as movement problems and eating difficulties

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. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

  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
Can genetic testing find the cause and the inheritance pattern?
How are lactic acid levels monitored?
Which specialists, such as for the heart and liver, should be involved?

Quick facts

InheritanceMitochondrial

Changes in genes (also called variants) cause this condition. GARD lists mitochondrial inheritance but does not name a gene in this record.

GeneticNeurologicalInherited MetabolicMitochondrial

Also known as: cytochrome c oxidase deficiency; cytochrome-c oxidase deficiency; cytochrome-c oxidase deficiency disease; isolated cox (cytochrome c oxidase) deficiency; isolated cox deficiency; isolated cytochrome c oxidase deficiency

Patient organizations

Source: NIH GARD · Mitochondrial complex IV deficiency, nuclear-typeGARD ID 48 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

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