Post mortem histopathological studies of brains have shown the presence of albumin in the cytoplasm of reactive astrocytes in patients with MNGIE, as compared to age-matched healthy individuals, suggesting functional blood brain barrier alterations and consequent vasogenic oedema as a cause of leukoencephalopathy in MNGIE [34]. Here, ALB is linked to mitochondrial neurogastrointestinal encephalomyopathy.