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A 69\u2010year\u2010old woman was admitted due to fatigue, general weakness, and a drowsy mental status. A brain magnetic resonance imaging (MRI) demonstrated multifocal lesions of increased T2 signal intensity, and laboratory findings were consistent with Fanconi syndrome. During her hospital course, she developed seizures, stress\u2010induced cardiomyopathy, and respiratory failure. A muscle biopsy demonstrated ragged\u2010red fibers in the muscle tissues seen in mitochondrial myopathy. We confirmed an 8\u00a0kb deletion in her mitochondrial DNA. Following treatment with <jats:sc>l<\/jats:sc>\u2010carnitine, coenzyme Q10, and supportive measures, brain lesions on MRI scans disappeared, and the general symptoms gradually improved.<\/jats:p>","DOI":"10.1111\/1756-185x.13575","type":"journal-article","created":{"date-parts":[[2019,4,10]],"date-time":"2019-04-10T07:06:17Z","timestamp":1554879977000},"page":"1152-1156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Case study of an inborn error manifested in the elderly: A woman with adult\u2010onset mitochondrial disease mimicking systemic vasculitis"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5668-4793","authenticated-orcid":false,"given":"Jae Hyun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital Seoul National University College of Medicine Seoul 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