Park SY, Hong SM, Lee HY, Kim MY, Lee HK, Han JY, Cho HJ, Oh SI, Lee H. Mitochondrial myopathy revealed postoperative acute respiratory failure: A case report. World J Clin Cases 2025; 13(15): 102691 [DOI: 10.12998/wjcc.v13.i15.102691]
Corresponding Author of This Article
Hongyeul Lee, MD, Assistant Professor, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, South Korea. yeurry@naver.com
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 26, 2025; 13(15): 102691 Published online May 26, 2025. doi: 10.12998/wjcc.v13.i15.102691
Mitochondrial myopathy revealed postoperative acute respiratory failure: A case report
Seon Yeong Park, Sung Min Hong, Ho Young Lee, Mi-Yeong Kim, Hyun-Kyung Lee, Ji-Yeon Han, Hwa Jin Cho, Seong-Il Oh, Hongyeul Lee
Seon Yeong Park, Sung Min Hong, Ho Young Lee, Mi-Yeong Kim, Hyun-Kyung Lee, Hongyeul Lee, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan 47392, South Korea
Ji-Yeon Han, Depart of Radiology, Inje University Busan Paik Hospital, Busan 47392, South Korea
Hwa Jin Cho, Department of Pathology, Busan and Gyeongnam Reference Lab, Seegene Medical Foundation, Busan 48792, South Korea
Seong-Il Oh, Department of Neurology, Kyung Hee University Hospital, Seoul 02447, South Korea
Author contributions: Park SY was responsible for data collection and writing and revising the first draft of the paper; Hong SM and Lee HY were involved in the critical care of the patient; Kim MY and Lee HK were conceptualized, designed the project; Han JY, Cho HJ, and Oh SI were instrumental and responsible for data reanalysis and reinterpretation, figure plotting, and the comprehensive literature search; Lee H played an indispensable role in the experimental design, data interpretation, and manuscript preparation of the corresponding authors. All authors have read and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hongyeul Lee, MD, Assistant Professor, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, South Korea. yeurry@naver.com
Received: October 29, 2024 Revised: December 23, 2024 Accepted: January 7, 2025 Published online: May 26, 2025 Processing time: 86 Days and 1.5 Hours
Abstract
BACKGROUND
Mitochondrial myopathies are characterized by primary dysfunction of the mitochondrial respiratory chain; they typically present as chronic muscle weakness. Clinically visible acute respiratory dysfunctions associated with mitochondrial myopathies occur rarely.
CASE SUMMARY
In this report, we present the case of a patient who developed postoperative hypoventilation after undergoing an uneventful administration of general anesthesia. A 34-year-old woman with no family history of myopathy underwent laparoscopic removal of a right-sided ureteric stone. Two days postoperatively, her oxygen saturation decreased rapidly, and blood gas analysis revealed hypercapnia. We promptly intubated and initiated the patient and initiated her on mechanical ventilation as she remained awake. Clinical examination findings were unremarkable; the results of laboratory investigations, including those for thyroid, hepatic, renal, and neuromuscular functions, were within normal limits. Muscle biopsy revealed muscle fibers of varying sizes as well as several degenerating and regenerating myofibers. Modified Gomori trichrome staining of the cross-sections revealed ragged red fibers. Based on these findings, we diagnosed the patient with mitochondrial myopathy. The patient’s condition gradually improved, and she was discharged on a home ventilator 73 days postoperatively.
CONCLUSION
Our case highlights that mitochondrial myopathy should be considered in the differential diagnosis of patients with postoperative respiratory failure.
Core Tip: Mitochondrial myopathies typically present with chronic muscle weakness, and acute respiratory dysfunction is an uncommon symptom. We report the case of a 34-year-old woman who experienced postoperative hypoventilation after undergoing an uneventful administration of general anesthesia. Reports on mitochondrial myopathy-related respiratory failure in adults are limited. In this case, the patient did not exhibit typical signs and symptoms of mitochondrial myopathy and remained asymptomatic until she was exposed to a general anestheic. Mitochondrial myopathy should be considered in the differential diagnosis of postoperative respiratory failure, and the diagnosis should be confirmed with a muscle biopsy.
