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CASE REPORT A 35-year-female presented with generalized weakness, weight loss and nausea along with progressive pigmentation involving both palmar and dorsal aspect of hands including knuckles, creases, feet, tongue, oral mucosa and gluteal region over a period of one year [Figure 1]

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613 To mitigate the risks associated with mito-nuclear interactions after mitochondrial replacement, it is recommended to match mitochondrial genotypes between donors and recipients and to determine acceptable variation levels between donor and patient mtDNA haplotypes