Mitochondrial disease
Gene: COQ5
PMID: 29044765 3 siblings with cerebellar ataxia, encephalopathy, seizures, developmental delay, and oculomotor apraxia or nystagmus.. All homozygous for a tandem duplication of 9.59kb encompassing the last 4 exons. Parents both shown to be carriers and 3 siblings were either het or did not have the dup. qRT-PCR in patient fibroblasts showed COQ5 mRNA levels were at 2-4% compared to controls. Reduced COQ5 protein was also shown on western blots.
PMID: 37599337 1 patient compound heterozygous for c.681+1G>A and Gly118Ser. Cerebellar ataxia, encephalopathy, developmental delay, short stature, and microcephaly. COQ5 mRNA levels were markedly diminished in patient cells, and different mis-splicing events were seen on both alleles (confirmed in carrier parents). This paper also referenced another patient in PMID: 21937992, a large ID cohort with limited phenotypic information who was homozygous for the same missense variant in their patient Gly118Ser.
PMID: 41199775 2 siblings with a different missense at the recurring amino acid Gly118, Gly118Asp, in trans with an NMD predicted frameshift. Both siblings had severe developmental delay, microcephaly, spasticity, ataxia, seizures, and feeding difficulties. Recurrent strokes and other brain anomalies commonly seen in mitochondrial disorders were seen on brain MRI, but there was no cerebellar atrophy. 1 sibling also had retinitis pigmentosa. Yeast modelling of this missense variant showed yeast harboring p.Gly118Asp (yeast equivalent) had decreased CoQ6 levels and an accumulation of the COQ5 yeast-equivalent substrate, DDMQ suggesting LOF.
PMID: 36266294 2 probands with retinitis pigmentosa from 2 families, 1 individual had symptoms onset at 49 years old with no other features while the 2nd had onset at 5 years old and also had muscular weakness and hypertelorism. Both patients had COQ5 c.682-7T>G which has 285 hets but no homs in gnomad v4. RT-PCR on patient cells showed majority exon 5 skipping, and minor exon 4+5 skipping, both out of frame and predicted to cause NMD. The major splicing event was seen in 56% of transcripts for that allele, so normal splicing is still occurring and its not a complete LOF allele. Both patients had different 2nd hits, Tyr311* and Arg123Trp.
The two patients in PMID: 36266294 are phenotypic outliers, PMID: 41199775 suggests you need a mutation affecting Gly118 to cause severe multisystem disease. Gly118 is in a might conserved DVAGGSG motif which is essential for binding S-adenosylmethionine. All other cases have a missense at this residue except for the family with the large duplication.Created: 26 Nov 2025, 2:31 p.m. | Last Modified: 26 Nov 2025, 2:31 p.m.
Panel Version: 1.3660
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Coenzyme Q10 deficiency, primary, 9 MIM#619028
Publications
Three siblings reported, bi-allelic duplications in gene, said to lead to reduced CoQ10.
Sources: Expert listCreated: 18 Mar 2020, 6:03 p.m.
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Coenzyme Q10 deficiency, primary 9, MIM#619028; Cerebellar ataxia; encephalopathy; generalized tonic-clonic seizures; intellectual disability
Publications
Only one reported family, without functional assays linking the gene to ataxia.
Sources: Expert listCreated: 16 Jan 2020, 4:29 p.m.
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Cerebellar ataxia; encephalopathy; generalized tonic-clonic seizures; intellectual disability
Publications
Phenotypes for gene: COQ5 were changed from Coenzyme Q10 deficiency, primary 9, MIM#619028; Cerebellar ataxia; encephalopathy; generalized tonic-clonic seizures; intellectual disability to Coenzyme Q10 deficiency, primary, 9 MIM#619028
Publications for gene: COQ5 were set to 29044765
Gene: coq5 has been classified as Green List (High Evidence).
Gene: coq5 has been classified as Green List (High Evidence).
Phenotypes for gene: COQ5 were changed from Cerebellar ataxia; encephalopathy; generalized tonic-clonic seizures; intellectual disability to Coenzyme Q10 deficiency, primary 9, MIM#619028; Cerebellar ataxia; encephalopathy; generalized tonic-clonic seizures; intellectual disability
Gene: coq5 has been classified as Red List (Low Evidence).
gene: COQ5 was added gene: COQ5 was added to Mitochondrial disease. Sources: Expert list Mode of inheritance for gene: COQ5 was set to BIALLELIC, autosomal or pseudoautosomal Publications for gene: COQ5 were set to 29044765 Phenotypes for gene: COQ5 were set to Cerebellar ataxia; encephalopathy; generalized tonic-clonic seizures; intellectual disability Review for gene: COQ5 was set to RED