A follow-up study in a Taiwanese family with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes syndrome

Jie Yuan Li, Rong Hong Hsieh, Nan Jing Peng, Ping Hong Lai, Cheng Feng Lee, Yuk Keung Lo, Yau Huei Wei

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background/Purpose: MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes) syndrome is often associated with A3243G point mutation of mitochondrial DNA (mtDNA). We previously described a MELAS family characterized by harboring an additional ∼ 260 bp tandem duplication in the D-loop and a novel C3093G point mutation in the 16S rRNA gene of mtDNA in the proband. We studied the clinical progression and fluctuation of mtDNA mutations in this Taiwanese MELAS family. Methods: We followed up the clinical course in all members of this family (1 proband, her mother and 3 sons) for 12 years. Mutations of mtDNA in serial muscle biopsies of the proband and blood samples and hair follicles taken at different time points from the members of this family were analyzed. Results: The proband developed repeated stroke-like episodes, chronic intestinal pseudo-obstruction, polyneuropathy, progressive renal failure and dilated cardiomyopathy with heart failure. During the follow-up period, the mother and one of the siblings of the proband developed stroke-like episodes at age 62 and 12, respectively. There was no significant difference in the proportions of mtDNA with A3243G mutation among five serial muscle biopsies of the proband. In one carrier (1-2), the proportion of A3243G mutated mtDNA in blood cells was slightly increased with disease progression. Conclusion: This study underlines the importance of early detection of extraneuromuscular symptoms in the members of a family with MELAS syndrome by adequate follow-up. The age of onset of stroke-like episode in MELAS syndrome may be as late as 62 years. We suggest that the manifestations of MELAS syndrome in this family might be associated with the additional ∼ 260 bp tandem duplication in the D-loop region and the coexistence of C3093G mutation in the 16S rRNA gene with the A3243G mutation of mtDNA.

Original languageEnglish
Pages (from-to)528-536
Number of pages9
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Volume106
Issue number7
DOIs
Publication statusPublished - Jul 2007

Keywords

  • Follow-up study
  • MELAS
  • Mitochondrial disease
  • Mitochondrial DNA
  • Mutation

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'A follow-up study in a Taiwanese family with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes syndrome'. Together they form a unique fingerprint.

  • Cite this