[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-639065-105":59,"doc-detail-639065-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","case-356-difference-between-melas-and-leigh-disease-discussion-and-summary","Case 356 - Difference Between MELAS and Leigh Disease - Discussion and Summary","","Case 356 discusses mitochondrial DNA abnormalities underlying MELAS and Leigh disease, focusing on ATP production failure and the A3243G variation. It describes how abnormal mitochondrial tRNA translation patterns differ, how incidence thresholds relate to infantile MELAS, adult MELAS, and Leigh disease, and how prognosis and neuroimaging evolution present clinically. The case narrative links vomiting, convulsions, lactic acidosis, CT/MRI findings, and differential diagnoses based on non-vascular territory infarction and symmetric basal ganglia/thalamic lesions.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/case-356-difference-between-melas-and-leigh-disease-discussion-and-summary/639065/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/case-356-difference-between-melas-and-leigh-disease-discussion-and-summary/639065.png","ImageObject",300,407,{"name":92,"@type":93},"River Wang","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-12","2026-10-22",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What mitochondrial DNA abnormality is mentioned as the cause in this discussion?","Question",{"text":112,"@type":113},"The abnormality is called the A3243G variation, arising in mitochondria and leading to disorders in enzyme production for ATP generation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does the text relate incidence thresholds to MELAS vs Leigh disease?",{"text":117,"@type":113},"When abnormality incidences are 60–75% adult-type MELAS appears, 75–92% infantile MELAS appears, and more than 92% indicates Leigh disease.",{"name":119,"@type":110,"acceptedAnswer":120},"What neuroimaging clues are used to help differentiate MELAS and Leigh-related conditions?",{"text":121,"@type":113},"For MELAS, CT/MRI show infarction patterns not matching vascular territories in young adults, corresponding to symptoms along optic or auditory pathways. For symmetric basal ganglia and thalamus damage, a differential diagnosis includes Leigh encephalopathy and other adult-onset encephalopathies.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},639065,1793074075,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","The difference between MELAS and Leigh disease is  \nCase 356  \n2. Incidence of abnormal mitochondria DNA  \n【Discussion】  \nMitochondria contained in a single cell work to create energy of ATP from glucose, protein and lipid. Apart from nuclear DNA, mitochondria own circle DNA which produces mRNA, tRNA and finally protein for energy production (Because mitochondria have their own DNA, mitochondria are thought to have been incorporated in a cell in a process of cell evolution) (1, 2) . tRNA interprets information from mRNA every three nucleotide codons: as an example, tRNA carries Leucin, one of amino acids to create protein, under codons of AAU responded from UUA of mRNA. tRNA modified by Taurin can also carry Leucin under codons of AAU responded from mRNA with nucleotides of UUG. In a short, normal pattern of taurine-modified tRNA can carry Leucin under codons of AAU from both codons of UUA and UUG of mRNA. Non-Taurin-modified tRNA can carry Leucin only under codons of AAU responded from UUA of mRNA but not under codons of AAU responded from UUG. This abnormality is called A3243G variation (3, 4) . Then, a cell with mitochondria of A3243G abnormality has some disorder to create enzyme for producing ATP.  \nMore or less, an A3243G abnormality exists in human mitochondria. However, the rate of abnormality increases, abnormal expression emerges. When its abnormality incidences are during 60-75%, adult type MELAS (18 age or more) appears, when during 75-92%, infantile MELAS (less than 18 age) appears, and when > 92%, Leigh disease appears (3-7) .  \nLeigh disease is a disease with poor prognosis. Most patients with Leigh disease pass away by 12 years (7) . When the lesion appears in brain stem, fatal respiratory failure occurs. Its initiation usually occurs in less than 2 years afterbirth but can initiate at late age of around 3 or four years. At first, abnormal findings appear in basal ganglion most on MRI, followed by white matter and finally on brain stem of respiratory center.  \non brain stem of respiratory center.  \nMELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, stroke-like episodes) is categorized into two groups: infantile type (onset peak 16, life span = onset + mean 6 years), adult type (onset peak 32, life span = onset + mean 12 years) (4-6) . Characteristic symptoms of infantile type are vomiting, convulsion, hemiparesis and hemianopsia. Those of adult type MELAS are diabetes mellitus and auditory disturbance later followed by visual disturbance (4) . Image findings of CT and MRI are that infarction patterns do not meet vascular territories in young adults. The ischemic lesions are sometimes corresponded to symptoms:  \noptical pathway damages to visual disturbances, auditory pathway damages to auditory disturbances (5, 6) . It is borne in mind that in case of non-vascular territory infarction in young adults on CT or MRI, MELAS and sinus or venous thrombosis should be listed in differential diagnosis.  \nWhen symmetric damages of putamen, caudate nucleus and thalamus were found on MRI or CT, several diseases are listed: Creutzfeldt-Jacob disease, hypoglycemic encephalopathy, autoimmune encephalitis and subacute necrotizing encephalopathy called Leigh encephalopathy. Of these, Leigh encephalopathy appears in children while Creutzfeldt-Jacob disease, hypoglycemic encephalopathy and autoimmune encephalitis appear in adult. In our case, she experienced convulsion and vomiting twice by time of age, four. Brain CT showed the lesion with high attenuation of putamen, caudate nucleus and white matter of frontal lobe and MRI with T1WI, T2WI and Diffusion WI did show no abnormality, indicative of small hemorrhage or minute calcification. Now, she grew to age 8. She was in the process of under observation, suggestive of Leigh syndrome or child type MELAS. Based on A3243G abnormality, she was finally diagnosed young-typed MELAS  \n【Summary】  \nWe presented a four-year-old girl with vomiting and convulsion. Laboratory test","cbCaitNK7cu70xho","https://ap.wps.com/l/cbCaitNK7cu70xho","pdf",210585,"English","# Discussion\n## Mitochondrial DNA abnormality and A3243G variation\n## Clinical incidence thresholds and prognosis\n## Neuroimaging patterns and differential diagnosis\n# Summary","[{\"question\":\"What mitochondrial DNA abnormality is mentioned as the cause in this discussion?\",\"answer\":\"The abnormality is called the A3243G variation, arising in mitochondria and leading to disorders in enzyme production for ATP generation.\"},{\"question\":\"How does the text relate incidence thresholds to MELAS vs Leigh disease?\",\"answer\":\"When abnormality incidences are 60–75% adult-type MELAS appears, 75–92% infantile MELAS appears, and more than 92% indicates Leigh disease.\"},{\"question\":\"What neuroimaging clues are used to help differentiate MELAS and Leigh-related conditions?\",\"answer\":\"For MELAS, CT/MRI show infarction patterns not matching vascular territories in young adults, corresponding to symptoms along optic or auditory pathways. For symmetric basal ganglia and thalamus damage, a differential diagnosis includes Leigh encephalopathy and other adult-onset encephalopathies.\"}]","Case 356 - Difference Between MELAS and Leigh Disease - Discussion and Summary | PDF",1792701485]