Management considerations for stroke-like episodes in MELAS with concurrent COVID-19 infection

Sen, Kuntal; Harrar, Dana; Hahn, Andrea; Wells, Elizabeth; Gropman, Andrea

doi:10.1007/s00415-021-10538-1

Cited by 4 publications

(2 citation statements)

References 17 publications

(20 reference statements)

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“…Evidence that the immune system is altered by an energetic defect come from multiple reports where MD patients have similar presentations to patients with primary immunodeficiencies, including unusual infections not commonly diagnosed in immunocompetent people [48]. Leukopenia has been reported in different MDs, including Barth syndrome, Pearson syndrome, Leigh syndrome, and other nonsyndromic forms of MD [49][50][51][52][53][54][55][56]. Recurrent hypogammaglobulinemia and reductions in natural killer, total CD8 T cells, and CD8 memory T cells were also noted [57].…”

Section: Mitochondrial Diseasesmentioning

confidence: 99%

The Reciprocal Interplay between Infections and Inherited Metabolic Disorders

Tummolo,

Melpignano

2023

Microorganisms

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Infections represent the main cause of acute metabolic derangements and/or the worsening of the clinical course of many inherited metabolic disorders (IMDs). The basic molecular mechanisms behind the role of infections in these conditions have not been completely clarified. This review points out the different mechanisms behind the relationship between IMDs and infections, providing an overview of this still-under-investigated area. Classically, infections have been considered as the consequence of a compromised immune system due to a biochemical defect of energy production. An adjunctive pathogenetic mechanism is related to a genetically altered protein-attached glycans composition, due to congenital glycosilation defects. In addition, a dietary regimen with a reduced intake of both micro- and macronutrients can potentially compromise the ability of the immune system to deal with an infection. There is recent pre-clinical evidence showing that during infections there may be a disruption of substrates of various metabolic pathways, leading to further cellular metabolic alteration. Therefore, infective agents may affect cellular metabolic pathways, by mediation or not of an altered immune system. The data reviewed here strongly suggest that the role of infections in many types of IMDs deserves greater attention for a better management of these disorders and a more focused therapeutic approach.

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Section: Mitochondrial Diseasesmentioning

confidence: 99%

The Reciprocal Interplay between Infections and Inherited Metabolic Disorders

Tummolo,

Melpignano

2023

Microorganisms

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“…However, by searching PubMed with the terms "mitochondrial, COVID* OR mitochondrial, coronavirus*", to date (3 November 2021), there is no empirical evidence of a heightened risk for a severe outcome of COVID-19 in these subjects, except from an isolated report of a patient with pre-existing severe MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) further complicated by COVID-19 [3].…”

mentioning

confidence: 99%