Intestinal pseudoobstructions and gastric necrosis in mitochondrial myopathy

Deutsche medizinische Wochenschrift
K MuehlenbergK H Wiedmann

Abstract

A 24-year-old female patient suffered for 4 months from recurrent abdominal pain, vomiting and diarrhea. Signs of an acute abdomen were the initial reason for admitting the patient to our hospital. The slim, pale patient had a complete bloated abdomen. Neurological status was normal. Radiographic examination showed a paralytic ileus with a megacolon. The recurrent abdominal symptoms were due to a covered perforation of the stomach. This was shrunken, scarred and had to be resected. Further intestinal pseudoobstructions were accompanied by substantial exsudations in the lungs, intestines and abdomen. At this time mutism like behavior patterns and an ophthalmoplegia appeared. Leukoencephalopathy in brain MRI scans and increased liquor-lactate suggested mitochondrial myopathy. The diagnosis of a mitochondrial myopathy was confirmed by increased liquor-lactate level, muscle biopsy with ragged-red fibers as well as abnormal mitochondrias and molecular-genetic investigations (mtDNA point mutation A3243G). Associations to MELAS (mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes) and MNGIE (mitochondrial neuro-gastrointestinal encephalomyopathy) syndrome are discussed. Unclear recurrent gastrointestinal symp...Continue Reading

Citations

Jun 21, 2005·Der Internist·J Mössner
Jul 6, 2007·Orvosi hetilap·Márta KovácsAndrás Arató
Apr 15, 2015·Digestive Diseases and Sciences·Ralph Hurley O'DwyerAdil E Bharucha
Jan 26, 2010·CNS Spectrums·Aileen KimGail H Manos
Oct 14, 2020·JPEN. Journal of Parenteral and Enteral Nutrition·Josef Finsterer

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