Late-onset MELAS syndrome with mtDNA 14453G→A mutation masquerading as an acute encephalitis: A case report

Yuki Yokota, Makoto Hara, Takayoshi Akimoto, Tomotaka Mizoguchi, Yu Ichi Goto, Ichizo Nishino, Satoshi Kamei, Hideto Nakajima

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

Background: A unique patient with MELAS syndrome, who initially masqueraded as having acute encephalitis and was eventually diagnosed with MELAS syndrome harboring a mtDNA 14453G → A mutation, is described. Case presentation: A 74-year-old Japanese man was admitted to another hospital due to acute onset of cognitive impairment and psychosis. After 7 days he was transferred to our hospital with seizures and deteriorating psychosis. The results of primary ancillary tests that included EEG, CSF findings, and brain MRI supported the diagnosis of an acute encephalitis. HSV-DNA and antibodies against neuronal surface antigens in the CSF were all negative. With the assistance of the lactate peak on the brain lesions in the magnetic resonance spectroscopy image and genetic analysis of the biopsied muscle, he was eventually diagnosed with MELAS syndrome harboring mtDNA 14453G → A mutation in the ND6 gene. Conclusions: This case provides a caveat that MELAS syndrome can manifest in the symptoms and ancillary tests masquerading as an acute encephalitis caused by infection or autoimmunity. This is the first adult patient seen to harbor the mtDNA14453G → A with a unique onset, which broadens the phenotypic spectrum of MELAS syndrome associated with ND6 gene mutation.

Original languageEnglish
Article number247
JournalBMC Neurology
Volume20
Issue number1
DOIs
Publication statusPublished - 17 Jun 2020

Keywords

  • Encephalitis
  • Late-onset
  • MELAS
  • ND6 gene

Fingerprint

Dive into the research topics of 'Late-onset MELAS syndrome with mtDNA 14453G→A mutation masquerading as an acute encephalitis: A case report'. Together they form a unique fingerprint.

Cite this