{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:20:32Z","timestamp":1760149232977,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:00:00Z","timestamp":1689552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University","award":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"],"award-info":[{"award-number":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"]}]},{"name":"Technology Innovation R&amp;D Project of Chengdu Science and Technology Bureau","award":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"],"award-info":[{"award-number":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"]}]},{"name":"National Natural Science Foundation of China","award":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"],"award-info":[{"award-number":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"]}]},{"name":"Sichuan Science and Technology Program","award":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"],"award-info":[{"award-number":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"]}]},{"name":"Medical-Engineering Integration Interdisciplinary Talent Training Fund Project of West China Hospital, Sichuan University","award":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"],"award-info":[{"award-number":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"]}]},{"name":"Fundamental Research Funds for the Central Universities","award":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"],"award-info":[{"award-number":["ZYGD18009","2021-YF05-01325-SN","81870937","82071320","81901199","2019YJ0037","HXDZ22011","ZYGX2022YGRH017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>(1) Introduction: Symptom spectrum can be of great diversity and heterogeneity in mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) patients in clinical practice. Here, we report a case of MELAS presenting asymptomatic refractory hypotension with m.3243 A&gt;G mutation. (2) Case representation: A 51-year-old male patient presented with a headache, vertigo, and difficulty in expression and understanding. The magnetic resonance imaging of the brain revealed an acute stroke-like lesion involving the left temporoparietal lobe. A definitive diagnosis of MELAS was given after the genetic test identified the chrM-3243 A&gt;G mutation. The patient suffered recurrent stroke-like episodes in the 1-year follow-up. Notably, refractory hypotension was observed during hospitalizations, and no significant improvement in blood pressure was found after continuous use of vasopressor drugs and fluid infusion therapy. (3) Conclusions: We report a case of refractory hypotension which was unresponsive to fluid infusion therapy found in a patient with MELAS. Our case suggests that comprehensive management should be paid attention to during treatment. A further study on the pathological mechanism of the multisystem symptoms in MELAS would be beneficial to the treatment of patients.<\/jats:p>","DOI":"10.3390\/brainsci13071080","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:35:04Z","timestamp":1689554104000},"page":"1080","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Refractory Hypotension in a Late-Onset Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like Episodes (MELAS) Male with m.3243 A&gt;G Mutation: A Case Report"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9716-1569","authenticated-orcid":false,"given":"Youjie","family":"Wang","sequence":"first","affiliation":[{"name":"West China School of Medicine, Sichuan University, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enhui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, West China Hospital, Sichuan University, Guo Xue Xiang 37, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2969-5486","authenticated-orcid":false,"given":"Chen","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Neurology, West China Hospital, Sichuan University, Guo Xue Xiang 37, Chengdu 610041, China"},{"name":"Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, West China Hospital, Sichuan University, Guo Xue Xiang 37, Chengdu 610041, China"},{"name":"Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fan, H.C., Lee, H.F., Yue, C.T., and Chi, C.S. 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