Progressive External Ophthalmoplegia with Mitochondrial Dna Deletions, Autosomal Recessive 4, also known as adult-onset multiple mitochondrial dna deletion syndrome due to dguok deficiency, is related to portal hypertension, noncirrhotic, 1 and mitochondrial dna depletion syndrome 3. An important gene associated with Progressive External Ophthalmoplegia with Mitochondrial Dna Deletions, Autosomal Recessive 4 is DGUOK (Deoxyguanosine Kinase). Affiliated tissues include skeletal muscle and eye, and related phenotypes are dysphagia and progressive external ophthalmoplegia