Journal article
A Novel Form of Familial Congenital Muscular Dystrophy in Two Adolescents
Neuropediatrics, Vol.29(6), pp.289-293
1998
DOI: 10.1055/s-2007-973579
PMID: 10029346
Abstract
Abstract
We report on two brothers (the product of first-degree consanguineous marriage; aged 15 and 12 years) who presented with severe hypotonia at birth, proximal muscle weakness associated with delayed motor milestones but normal cognitive function. Investigations (at 4 years of age) revealed mildly elevated serum creatine kinase (CK) levels (300 and 824 IU/1; N ≤ 210). Muscle biopsies showed minimal change myopathy, no neurogenic atrophy but remarkable type-1 fibre predominance (up to 85.5 %) without fibre-type disproportion.
Clinical examination at 12 and 9 years, respectively, showed mild facial weakness and high-arched palate in both patients. The younger sibling also had ptosis but otherwise normal external ocular muscles. They showed symmetric proximal muscle weakness and wasting associated with calf-muscle hypertrophy. They could walk independently. A repeat muscle biopsy showed advanced dystrophic changes in the younger patient at the age of 10 years. Virtually all the remaining fibres were type 1.
Immunohistochemistry revealed normal expression of the dystrophin-glycoprotein complex (DGC), including dystrophin, β-dystroglycan, α-(adhalin), β-, γ-, and δ-sarcoglycan, Iaminin-α2 chain (merosin) and syntrophin. Mild dystrophic features and type-1 fibre predominance (92.5 %) were seen in the biopsy of the older patient, whereas immunohistochemistry showed normal expression of the DGC. Both cases also showed clear expression of integrin α7 at the muscle fibre surface and in the blood vessels.Three years later, they could still walk, but with difficulty, and the older brother showed enlargement of the tongue and echocardiographic features of left ventricular dilated cardiomyopathy.
Details
- Title: Subtitle
- A Novel Form of Familial Congenital Muscular Dystrophy in Two Adolescents
- Creators
- M. A Salih - Division of Pediatric Neurology, Department of Pediatrics andM Al Rayess - Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi ArabiaS Cutshall - Howard Hughes Medical Institute and Department of Physiology and Biophysics, University of Iowa, College of Medicine, Iowa City, IA, USAJ. A Urtizberea - AFM, Evry Cedex, France; andM. H Al-Turaiki - The Joint Centre for Research in Prosthetics and Orthotics and Rehabilitation Programmes, Riyadh, Saudi ArabiaC. O Ozo - Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi ArabiaV Straub - Howard Hughes Medical Institute and Department of Physiology and Biophysics, University of Iowa, College of Medicine, Iowa City, IA, USAM Akbar - The Joint Centre for Research in Prosthetics and Orthotics and Rehabilitation Programmes, Riyadh, Saudi ArabiaM Abid - Department of Radiology, Riyadh Armed Forces Hospital, Riyadh, Saudi ArabiaA Andeejani - Department of Radiology, Riyadh Armed Forces Hospital, Riyadh, Saudi ArabiaK. P Campbell - Howard Hughes Medical Institute and Department of Physiology and Biophysics, University of Iowa, College of Medicine, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Neuropediatrics, Vol.29(6), pp.289-293
- DOI
- 10.1055/s-2007-973579
- PMID
- 10029346
- ISSN
- 0174-304X
- eISSN
- 1439-1899
- Language
- English
- Date published
- 1998
- Academic Unit
- Neurology; Molecular Physiology and Biophysics; Iowa Neuroscience Institute
- Record Identifier
- 9984020732102771
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