MELAS Syndrome and Refeeding Syndrome in Pediatrics: A Case Report with A Fatal Outcome

Abstract

MELAS syndrome (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) is one of the most severe and complex mitochondrial diseases, characterized by its clinical heterogeneity and progressive course. We present the case of an 8-year-old pediatric patient with a confirmed diagnosis of MELAS, who experienced severe gastrointestinal episodes, refeeding syndrome, and metabolic complications, culminating in a fatal outcome. Through clinical analysis and a review of the literature, we emphasize the importance of a multidisciplinary approach that considers both neurological manifestations and associated digestive and nutritional complications.This report highlights the need for early surveillance protocols, comprehensive metabolic support management, and timely recognition of risks such as refeeding syndrome. It also underscores the urgent need to strengthen research and clinical guidelines adapted to the pediatric and hospital context in resource-limited settings.