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MELAS syndrome associated with a new mitochondrial tRNA-Val gene mutation (m.1616A>G)
  1. Yuka Toyoshima,
  2. Yuji Tanaka,
  3. Kazuo Satomi
  1. Department of Neurology, Gifu Municipal Hospital, Gifu City, Japan
  1. Correspondence to Dr Yuji Tanaka, yutanaka-gif{at}


We describe the case of a 40-year-old-man with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome, with cardiomyopathy and severe heart failure. He had a mitochondrial transfer RNA (tRNA) mutation (m.1616A>G) of the (tRNA-Val) gene, and it was not found in MELAS syndrome ever before. The presence of this newly observed tRNA-Val mutation (m.1616A>G) may induce multiple respiratory chain enzyme deficiencies and contribute to MELAS syndrome symptoms that are associated with mitochondrial DNA (mtDNA) mutations. We report that the pathognomonic symptom in MELAS syndrome caused by this newly observed mtDNA mutation may be rapid progression of cardiomyopathy and severe heart failure.

  • neurology
  • muscle disease

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  • Contributors YT: acquisition of data and analysis. YT: corresponding author. KS: study supervision.

  • Competing interests None declared.

  • Patient consent Obtained from guardian.

  • Provenance and peer review Not commissioned; externally peer reviewed.