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Living with Mitochondrial DNA depletion syndrome 9

A rare condition that affects infants, causing brain and muscle disease, high lactic acid, and severe developmental delay.

Understanding Mitochondrial DNA depletion syndrome 9

Mitochondrial DNA depletion syndrome 9 is a rare neurometabolic condition that affects infants, also known as infantile lactic acidosis with methylmalonic aciduria.

It causes a severe disease of the brain and muscles (encephalomyopathy), high levels of lactic acid, and a substance called methylmalonic acid in the urine. Signs include severe developmental delay and low muscle tone. It can also cause trouble gaining weight, feeding difficulties, and involuntary muscle contractions. Epilepsy and other birth differences may be present. Signs start in the newborn period or infancy.

Signs & symptoms

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

  • Low muscle tone in infancy (floppy infant)
  • Delays in reaching developmental milestones
  • Trouble gaining weight and feeding difficulties
  • Brain disease (encephalopathy)
  • Enlarged liver
  • Muscle wasting

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, digestive system specialists and genetic specialists.

  3. Consider genetic testing

    Changes in SUCLG1 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); Digestive system specialists (gastroenterologists); 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 for the SUCLG1 gene confirm this diagnosis?
What feeding support is available for my child?
Which specialists should be on my child's care team?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive, Mitochondrial
GenesSUCLG1

This condition is caused by changes in the SUCLG1 gene. It is autosomal recessive, which means a child inherits a changed copy of the gene from each parent.

GeneticNeurologicalGastrointestinalInherited MetabolicMitochondrial

Also known as: fatal infantile lactic acidosis; fatal infantile lactic acidosis co-occurrent with methylmalonic aciduria; fatal infantile lactic acidosis with methylmalonic aciduria; mitochondrial dna depletion syndrome caused by mutation in suclg1; mitochondrial dna depletion syndrome type 9; mtdps9

Patient organizations

Source: NIH GARD · Mitochondrial DNA depletion syndrome 9GARD ID 3163 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

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