Mucosal necrosis of the small intestine in myopathy, encephalopathy, lactic acidosis, and stroke-like episodes syndrome

This report presents a case of massive mucosal necro- sis of the small intestine in a patient with mitochon- drial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), which particularly affects the brain, nervous system and muscles. A 45-year-old Japanese female, with an est...

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Veröffentlicht in:World journal of gastroenterology : WJG 2012-11, Vol.18 (41), p.5986-5989
Hauptverfasser: Fukuyama, Keita, Ishikawa, Yasuhide, Ogino, Tetsuro, Inoue, Hidenobu, Yamaoka, Ryoya, Hirose, Tetsuro, Nishihira, Tomohiko
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Sprache:eng
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Zusammenfassung:This report presents a case of massive mucosal necro- sis of the small intestine in a patient with mitochon- drial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), which particularly affects the brain, nervous system and muscles. A 45-year-old Japanese female, with an established diagnosis of ME- LAS, presented with vomiting. Computed tomography showed portomesenteric venous gas and pneumatosis intestinalis. She underwent a resection of the small intestine. A microscopic study showed necrosis of the mucosa and vacuolar degeneration of smooth muscle cells in the arterial wall. Immunohistochemistry showed anti-mitochondrial antibody to be highly expressed in the crypts adjacent the necrotic mucosa. The micro- scopic and immunohistochemical findings suggested the presence of a large number of abnormal mitochon- dria in MELAS to be closely linked to mucosal necrosis of the small intestine.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v18.i41.5986