Abstract
The article by Toki et al. summarizing three patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episode (MELAS) who experienced a fulminant-onset hyperglycemic crisis as the first manifestation of mitochondrial diabetes is of interest. 1 Toki T. Shimizu-Motohashi Y. Komaki H. et al. Hyperglycemic crisis in patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). Pediatr Neurol. 2020; 114: 1-4 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar Hyperglycemic events occurred after surgery, infection, and status epilepticus, respectively. 1 Toki T. Shimizu-Motohashi Y. Komaki H. et al. Hyperglycemic crisis in patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). Pediatr Neurol. 2020; 114: 1-4 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar These authors concluded that patients with MELAS should routinely undergo measurement for glycated hemoglobin (HbA1c) regardless of age and lack of symptoms. 1 Toki T. Shimizu-Motohashi Y. Komaki H. et al. Hyperglycemic crisis in patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). Pediatr Neurol. 2020; 114: 1-4 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar I have several observations.
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