肌阵挛性癫痫伴破碎红纤维综合征(myoclonic epilepsy with ragged red fibers,MERRF)是遗传性线粒体病中相对罕见的一种,多为母系遗传,以肌阵挛癫痫及肌肉活检可见破碎红纤维(ragged redfibers,RRF)特征而得名。其发病机制尚不明确,早...肌阵挛性癫痫伴破碎红纤维综合征(myoclonic epilepsy with ragged red fibers,MERRF)是遗传性线粒体病中相对罕见的一种,多为母系遗传,以肌阵挛癫痫及肌肉活检可见破碎红纤维(ragged redfibers,RRF)特征而得名。其发病机制尚不明确,早期研究结果提示氧化磷酸化障碍为其一致病机制[1]。现尚无特效的治疗方法,多学科和个体化诊疗可改善患者整体预后[1]。本文就MERRF临床诊断依据及管理进行综述。展开更多
We report a 51-year-old alcoholic man with a 10-year history of cervical lipomas and progressive symmetrical sensory neuropathy, initially diagnosed with Madelung’s disease, an idiopathic syndrome often attributed to...We report a 51-year-old alcoholic man with a 10-year history of cervical lipomas and progressive symmetrical sensory neuropathy, initially diagnosed with Madelung’s disease, an idiopathic syndrome often attributed to chronic alcoholism. The eventual development of proximal weakness led to pathological and genetic testing which identified a A8344G mutation in the mitochondrial tRNA lysine gene, associated with MERRF (myoclonic epilepsy with ragged-red fibers). This case demonstrates how the varied terminology for this syndrome has resulted in a lack of consistent recognition and assessment for mitochondrial cytopathy.展开更多
Background: The mitochondrial DNA gene encoding subunit 5 of complex I (ND5) has turned out to be a hot spot for mutations associated with mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (...Background: The mitochondrial DNA gene encoding subunit 5 of complex I (ND5) has turned out to be a hot spot for mutations associated with mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS) and various overlap syndromes. Objective: To describe a novel mutation in the ND5 gene in a young man man with an overlap syndrome of MELAS and myoclonus epilepsy with ragged-red fibers. Design: Case report. Patient: A 25-year-old man had recurrent strokes, seizures, and myoclonus. His mother also had multiple strokes. A muscle biopsy specimen showed no ragged-red fibers but several strongly succinate dehydrogenasereactive blood vessels. Results: Biochemical analysis showed isolated complex I deficiency and molecular analysis revealed a novel heteroplasmic mutatio n (G13042A) in the ND5 gene. Conclusions: These data confirm that ND5 is a genet ic hot spot for overlap syndromes, including MELAS and strokelike and myoclonus epilepsy with ragged-red fibers.展开更多
文摘肌阵挛性癫痫伴破碎红纤维综合征(myoclonic epilepsy with ragged red fibers,MERRF)是遗传性线粒体病中相对罕见的一种,多为母系遗传,以肌阵挛癫痫及肌肉活检可见破碎红纤维(ragged redfibers,RRF)特征而得名。其发病机制尚不明确,早期研究结果提示氧化磷酸化障碍为其一致病机制[1]。现尚无特效的治疗方法,多学科和个体化诊疗可改善患者整体预后[1]。本文就MERRF临床诊断依据及管理进行综述。
文摘We report a 51-year-old alcoholic man with a 10-year history of cervical lipomas and progressive symmetrical sensory neuropathy, initially diagnosed with Madelung’s disease, an idiopathic syndrome often attributed to chronic alcoholism. The eventual development of proximal weakness led to pathological and genetic testing which identified a A8344G mutation in the mitochondrial tRNA lysine gene, associated with MERRF (myoclonic epilepsy with ragged-red fibers). This case demonstrates how the varied terminology for this syndrome has resulted in a lack of consistent recognition and assessment for mitochondrial cytopathy.
文摘Background: The mitochondrial DNA gene encoding subunit 5 of complex I (ND5) has turned out to be a hot spot for mutations associated with mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS) and various overlap syndromes. Objective: To describe a novel mutation in the ND5 gene in a young man man with an overlap syndrome of MELAS and myoclonus epilepsy with ragged-red fibers. Design: Case report. Patient: A 25-year-old man had recurrent strokes, seizures, and myoclonus. His mother also had multiple strokes. A muscle biopsy specimen showed no ragged-red fibers but several strongly succinate dehydrogenasereactive blood vessels. Results: Biochemical analysis showed isolated complex I deficiency and molecular analysis revealed a novel heteroplasmic mutatio n (G13042A) in the ND5 gene. Conclusions: These data confirm that ND5 is a genet ic hot spot for overlap syndromes, including MELAS and strokelike and myoclonus epilepsy with ragged-red fibers.