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ミトコンドリア・ロイシン転移RNA tRNALeu(UUR)の3254点変異1例と3243点変異2例の臨床的特徴を比較した。3243変異例1はmitochondrial myopathy, encephalopathy, lactic acidosis and stroke like episodes(MELAS)の臨床症状に加え,多彩な内分泌障害を認めた。3243変異例2は外眼筋麻痺と知能低下を主症状とし,頭痛は認めたが梗塞病変はなかった。3254変異例は心不全が主症状で,梗塞病変はなかった。3症例にragged red fiber(RRF),strongly SDH-reactive blood vessels(SSV)陽性,cytochrome Coxydase(CCO)欠損を認め,軽度の筋力低下を認めた。以上,ロイシン転移RNA点突然変異を認めるミトコンドリア脳筋症は多彩な表現型を呈しうる。
We compared clinical pictures of a case of mito-chondrial encephalomyopathy with tRNALeu (UUR)point mutation at nucleotide position 3254 of mito-chondrial DNA with those at position 3243. The mutation 3254 was a 19-year-old male patient with cardiomyopathy accompanied with muscle atrophy. The first mutant 3243 was a 31-year-old female patient showing clinical features of MELAS and endocrinological abnormalities. The second 3243 mutant was a 27-year-old male patient who had an external ophthalmoplegia and slight mental decline.
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