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Respiratory failure Possible treatment: Thiamine, Arginine, Carnitine, Biotin, CoQ10 Laboratory Anemia: Low iron Lactic acidosis Muscle biopsy Aggregates Complex III deficiency, Isolated: Mild to Severe LYRM7 protein: Reduced Serum CK: Normal Brain MRI White matter: Leukoencephalopathy Demyelination Vacuolization, Cysts, or Cavitations: Some patients Spinal cord: Abnormal signal Global atrophy Corpus callosum: Thin Mitochondrial complex III deficiency, nuclear type 9 (Complex III): Encephalopathy (MC3DN9) Ubiquinol-cytochrome c reductase complex assembly factor 3 (C11orf83, UQCC3, CBP4)