Presentation summary

Introduction :
Myopathy, lactic acidosis, and sideroblastic anemia type 2 (MLASA2) is a mitochondrial disorder caused by YARS2 mutations, leading to impaired energy metabolism, increased vulnerability to infections, and prolonged recovery. Patients are at higher risk for sepsis and critical complications. We present a rare pediatriccase of MLASA2 with suspected viral encephalitis complicated by septic shock, who showed notable improvements in consciousness and motor function following adjunctive low-level laser acupuncture (LLLT).

Method :
A 14-year-old girl with genetically confirmed MLASA2 was admitted for acute consciousness disturbance following fever and seizures, suspected to be viral encephalitis or encephalopathy. She receivedantibiotics, IVIG, anticonvulsants, and a mitochondrial cocktail therapy, yet remained drowsy with generalized weakness. From a Traditional Chinese Medicine viewpoint, she was diagnosed with “spleen-kidney deficiency with heat entering the pericardium.” Adjunctive LLLT was started using Nogier A frequency (292 Hz, 880 nm).Laser energy (2.5 J/point) was applied to KI1, KI3, KI7, SP9, PC6, GV20, and 5 J to Jing-well points. Treatment was performed daily, five days per week.

Results :
After two days of LLLT, the patient’s consciousness improved, and she began responding to limbstimulation. By the third day, she could follow commands, and her limb motor strength continued to recover progressively.

Conclusion :
LLLT may be a safe, non-invasive therapy that supports neurological recovery and peripheral circulation in critically ill mitochondrial disease patient complicated by septic shock following viral encephalitis.Written informed consent was obtained from the patient and her family.