Review for 10.1186/s12876-018-0925-5 (2019)

Reviewer ’s report  
 
Title:  Mitochondrial neurogastrointestinal encephalopathy as a mimic o f Crohn's disease: a case 
report  
 
Version: 0 Date: 06 Jul 2018 
 
Reviewer:  Nicola  Imperatore  
 
Reviewer’s report:  
 
It is a pleasure for me to read this well -written and very interesting article.  
 
The authors reported two cases of MNGIE previously misdiagnosed with Crohn's disease. 
Furthermore, the authors identified a new variant in TYMP mutation and proposed a pathological 
mechanism of neurologic worsening during azathioprine treatment.  
 
I believe that this article add further knowledge in a frequent misdiagnosed condition like 
MNGIE.  
 
 
I have some comments that I believe can improve the pap er: 
 
1. How did the Authors treat both patients? Have the Authors planned a specific treatment in the 
next future (i.e. allogenic hematopoietic stem cell transplantation)?  
 
2. A recent paper reported a case of MNGIE misdiagnosed as refractory celiac diseas e, in which 
several clinical and radiological features were similar to those reported in the current manuscript 
(Imperatore N, et al. Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) 
mimicking refractory celiac disease. Dig Liver Dis. 2017). P lease comment  
 
3. The Authors should add more info about treatment for MNGIE  
 
- D'Angelo R, Rinaldi R, Pironi L, etal. Liver transplant reverses biochemical imbalance in 
mitochondrial neurogastrointestinal encephalomyopathy. Mitochondrion 2017,pii:S1567 -
7249(16)30250 -1.  
 
- De Giorgio R, Pironi L, Rinaldi R, etal.Liver transplantation for mitochondrial 
neurogastrointestinal encephalomyopathy. Annals of Neurology 2016;80:448 -55. 
 
Are the  methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the public ation of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the  above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will  be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available unde r an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as  confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal