Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan.
Department of Internal Medicine, Sodegaura Satsuki-dai Hospital, Japan.
Intern Med. 2020 Nov 1;59(21):2773-2776. doi: 10.2169/internalmedicine.4922-20. Epub 2020 Jul 7.
We herein present a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), who developed serious acute renal failure with lactic acidosis, followed by rhabdomyolysis. Despite receiving intensive care, he suffered multiple cardiopulmonary arrests and died 10 days after presentation due to a sudden deterioration of his symptoms. Renal pathology revealed diffuse tubular necrosis with interstitial edema and tubular dilatation on light microscopy, and a severe degeneration of intracellular organelles on electron microscopy. These pathological findings could have resulted from multiple cardiopulmonary arrests; however, we must be aware of the extremely rare but sudden occurrence of these fatal conditions in MELAS patients.
我们在此介绍一位线粒体肌病、脑病、乳酸酸中毒和卒中样发作（MELAS）患者，他在发生乳酸酸中毒和随后的横纹肌溶解症后出现严重的急性肾衰竭。尽管接受了重症监护，但他还是多次发生心肺骤停，并在发病后 10 天因症状突然恶化而死亡。肾脏病理显示，光镜下弥漫性肾小管坏死伴间质水肿和肾小管扩张，电镜下细胞内细胞器严重变性。这些病理发现可能是多次心肺骤停所致；然而，我们必须意识到 MELAS 患者中这些罕见但突然发生的致命情况。
