Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 9 4 2025 02 22 186 191 EN Sriram Mudraje Department of Endocrinology, People’s College of Medical Sciences and Research Centre, Bhopal,India. Jaideep Khare Department of Endocrinology, People’s College of Medical Sciences and Research Centre, Bhopal,India. Nancy Garg Department of Endocrinology, People’s College of Medical Sciences and Research Centre, Bhopal,India. Sushil Jindal Department of Endocrinology, People’s College of Medical Sciences and Research Centre, Bhopal,India. 2024 12 20 2025 01 05 Kearns-Sayre syndrome is a rare mitochondrial disease that presents before the age of 20 years with ptosis, external ophthalmoplegia, and pigmentary retinopathy associated with endocrine and cardiac conduction abnormalities. Here we report an 18-year-old female presenting with fever, cough, secondary amenorrhea, diabetes ptosis, external ophthalmople gia, and ataxia . Fundosc opy revealed pigmen tary retinopathy. ECG showed intraventricular conduction abnormalities, and 2D echocardiography revealed global left ventricular hypokinesia with reduced ejection fraction. Hence, the diagnosis of Kearns-Sayre syndrome was made. https://crcp.tums.ac.ir/index.php/crcp/article/view/1010 https://crcp.tums.ac.ir/index.php/crcp/article/download/1010/682