期刊
BMJ CASE REPORTS
卷 14, 期 11, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bcr-2021-245898
关键词
fluid electrolyte and acid-base disturbances; unwanted effects; adverse reactions; pharmacology and therapeutics; stroke
MELAS is a mitochondrially inherited multisystem disorder that can present with acute stroke-like episodes. While L-arginine therapy is supported in acute MELAS flares, it may not be suitable for all patients, as demonstrated in this case.
MELAS, a mitochondrially inherited multisystem disorder, can present with acute stroke-like episodes. The literature thus far supports the use of L-arginine therapy in acute MELAS flares to alleviate and shorten the duration of symptoms. This is the case of a patient who presented with ataxia and worsening confusion on a background of genetically confirmed MELAS syndrome. In this instance, intravenous L-arginine therapy, along with corticosteroids, was administered in keeping with best practice. However, in a metabolically vulnerable patient, L-arginine therapy resulted in a further deterioration in his clinical status and the development of a non-anion gap metabolic acidosis.
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