• Turnaround time:
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  • Alternate specimens:
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BTHS; Barth syndrome; CMD3A; EFE; EFE2; G4.5; LVNCX; Taz1

Associated disorders

The TAZ gene is associated with X-linked Barth Syndrome (BTHS), also known as 3-methylglutaconic aciduria type II (MedGen UID: 107893), and dilated cardiomyopathy (DCM) (MedGen UID: 2880).

TAZ is the only gene associated with Barth syndrome.

The TAZ gene encodes the tafazzin protein which promotes cardiolipin acyl chain remodeling.


OMIM: 300394

Clinical condition

The TAZ gene is associated with X-linked Barth syndrome (BTHS), also known as 3-methylglutaconic aciduria type II (MedGen UID: 107893), and dilated cardiomyopathy (DCM; MedGen UID: 2880).
Barth syndrome is a multi-system disorder characterized by cardiomyopathy, neutropenia, skeletal myopathy, growth and/or developmental delay, increased 3-methylglutaconic acid, and distinct facial features in affected males (PMID: 1719174, 6142097, 19648820). Overall, phenotypic expression is widely variable among patients and in the same patients over time (PMID: 23045169). Carrier females are reported to be unaffected and without detectable biochemical abnormalities (PMID: 15098233). In families with pathogenic variants in TAZ, multiple miscarriages, fetal loss, or stillbirth of males has been reported (PMID: 20812380).

Cardiomyopathy is the most common feature and cause of death, frequently observed by one year of age and presenting as DCM or left ventricular non-compaction (LVNC; PMID: 15098233). DCM is defined by left ventricular dilation and systolic dysfunction, which may lead to heart failure, arrhythmias or conduction system disease, and thromboembolic disease (PMID: 15808750). LVNC occurs when the ventricular wall does not finish developing and retains a spongy or “trabeculated” appearance, causing a risk of heart failure, arrhythmia, and an increased risk for blood clots or stroke (PMID: 24282766). Variations in TAZ have also been reported in non-syndromic DCM and LVNC (PMID: 9382096, 12468278).

Skeletal myopathy typically presents as proximal and non-progressive muscle weakness affecting gross motor ability and can also affect grip (PMID: 23398819).

Characteristic biochemical findings in males include elevations of 3-methylglutaconic acid, 3-methylglutaric acid, and 2-ethylhydracrylic acid in urine or plasma, as well as an altered monolysocardiolipin to cardiolipin (CL) ratio in fibroblasts (PMID: 1719174, 16873891).

Gene information

The TAZ gene encodes the tafazzin protein, which promotes CL acyl chain remodeling by adding a linoleic acid to the molecule (PMID: 16873891). CL is found in the inner membrane of mitochondria, is required for maintaining the structure of respiratory chain complexes, and plays a role in oxidative phosphorylation (PMID: 16873891). Loss of function variants reduce the formation of the CL isoform predominantly found in cardiac and skeletal muscle, impairing their function (PMID: 23398819).


TAZ exhibits X-linked inheritance, and affected individuals are male. In an affected individual, a pathogenic variant is expected to be inherited from the mother or to occur de novo. Maternal genetic testing can help determine if a variant is inherited or de novo and inform recurrence risk for the siblings of an affected individual. Maternal germline mosaicism has been reported (PMID: 20303308, 23656970). Any female children of an affected male would inherit the pathogenic variant as unaffected carriers and male children would not inherit this variant.


Recommended management for cardiomyopathy (DCM and LVNC) includes a combination of medication, device therapy, and heart transplantation. Pre-symptomatic treatment may forestall symptoms and improve survival and quality of life. Surveillance of affected individuals includes periodic physical exams, echocardiograms, and ECG/EKG. It is recommended that management decisions be made based on clinical presentation, symptoms, and family history (PMID: 19254666).

Other management and surveillance recommendations include the following:

  • Cornstarch supplementation may be used to limit the degree of muscle wasting during overnight fasting (PMID: 23398819).
  • Symptomatic neutropenia is typically treated with prophylactic antibiotics (PMID: 23398819).
  • Patients with complex disease are best managed by a multidisciplinary team, including physical and occupational therapists, speech and language pathologists, and educational support workers (PMID: 23398819).
  • Genetic counseling and testing are recommended for at-risk family members of an individual with a pathogenic variant (PMID: 21787999).

Review date: December 2017

Assay and technical information

Invitae is a College of American Pathologists (CAP)-accredited and Clinical Laboratory Improvement Amendments (CLIA)-certified clinical diagnostic laboratory performing full-gene sequencing and deletion/duplication analysis using next-generation sequencing technology (NGS).

Our sequence analysis covers clinically important regions of each gene, including coding exons, +/- 10 base pairs of adjacent intronic sequence in the transcript listed below. In addition, analysis covers the select non-coding variants specifically defined in the table below. Any variants that fall outside these regions are not analyzed. Any specific limitations in the analysis of these genes are also listed in the table below.

Our analysis detects most intragenic deletions and duplications at single exon resolution. However, in rare situations, single-exon copy number events may not be analyzed due to inherent sequence properties or isolated reduction in data quality. If you are requesting the detection of a specific single-exon copy number variation, please contact Client Services before placing your order.

Gene Transcript reference Sequencing analysis Deletion/Duplication analysis
TAZ NM_000116.4