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Dotti MT, Malandrini A, Lornage X, Mignarri A, Cantisani TA, Bohm J, Laporte J, Malfatti E. Discordant manifestations in Italian brothers with GNE myopathy. J Neurol Sci 2018; 386:1-3. [PMID: 29406958 DOI: 10.1016/j.jns.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/13/2017] [Accepted: 01/03/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Maria-Teresa Dotti
- Neurology and Neurometabolic Unit, Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Alessandro Malandrini
- Neurology and Neurometabolic Unit, Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Xavière Lornage
- Departement of Translational Medicine and Neurogenetics, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U964, CNRS UMR7104, Strasbourg University, Illkirch, France
| | - Andrea Mignarri
- Neurology and Neurometabolic Unit, Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | | | - Johann Bohm
- Departement of Translational Medicine and Neurogenetics, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U964, CNRS UMR7104, Strasbourg University, Illkirch, France
| | - Jocelyn Laporte
- Departement of Translational Medicine and Neurogenetics, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U964, CNRS UMR7104, Strasbourg University, Illkirch, France
| | - Edoardo Malfatti
- Unité de Morphologie Neuromusculaire, Institut de Myologie, GHU La Pitié-Salpêtrière, Paris, France; Centre de référence de Pathologie Neuromusculaire Paris-Est, Institut de Myologie, GHU La Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
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2
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Bello R, Bertorini T. A Man With Distal Asymmetric Leg Weakness. J Clin Neuromuscul Dis 2017; 18:235-243. [PMID: 28538255 DOI: 10.1097/cnd.0000000000000147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
EDUCATIONAL OBJECTIVES To discuss a case of adult-onset asymmetric distal leg weakness in a patient who presented with weakness and atrophy of the posterior compartment of the left leg. KEY QUESTIONS 1. What is the differential diagnosis of asymmetric distal leg weakness?2. How would a clinician approach diagnostic testing for such a patient?3. What is the final diagnosis for this patient?4. How to treat this patient?
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Affiliation(s)
- Rey Bello
- *Clinical Neurophysiology-EMG/Neuromuscular Diseases, Memphis, TN; and †Department of Neurology, University of Tennessee Health Science Center, Memphis, TN
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3
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Abstract
In this article, distal myopathy syndromes are discussed. A discussion of the more traditional distal myopathies is followed by discussion of the myofibrillar myopathies. Other clinically and genetically distinctive distal myopathy syndromes usually based on single or smaller family cohorts are reviewed. Other neuromuscular disorders that are important to recognize are also considered, because they show prominent distal limb weakness.
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Affiliation(s)
- Mazen M Dimachkie
- Neuromuscular Section, Neurophysiology Division, Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA.
| | - Richard J Barohn
- Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA
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4
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Abstract
Hereditary inclusion body myopathy is an autosomal recessive disorder that presents in early adulthood with slowly progressive weakness sparing the quadriceps. Muscle histopathology reveals rimmed vacuoles without inflammation. The disorder is caused by a mutation in the gene for UDP-N-acetylglucosamine 2-epimerase-N-acetylmannosamine kinase (GNE), a bifunctional enzyme involved in protein glycosylation. Over 40 mutations have been described to date. We present a case of a young woman with progressive lower extremity weakness. Clinical presentation, laboratory evaluation, electrodiagnostic testing, muscle pathology, and genetic sequencing are described. The patient was found to have heterozygous mutations in the GNE gene, confirming the diagnosis of hereditary inclusion body myopathy. The mutations she carried have not been described previously. We briefly review the clinical, histopathologic, and molecular genetic findings of this disorder.
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5
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Jay CM, Levonyak N, Nemunaitis G, Maples PB, Nemunaitis J. Hereditary Inclusion Body Myopathy (HIBM2). GENE REGULATION AND SYSTEMS BIOLOGY 2009; 3:181-90. [PMID: 20054407 PMCID: PMC2796972 DOI: 10.4137/grsb.s2594] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Hereditary inclusion body myopathy type 2 (HIBM2) is a myopathy characterized by progressive muscle weakness with early adult onset. The disease is the result of a recessive mutation in the Glucosamine (UDP-N-acetyl)-2-epimerase/N-acetylmannosamine kinase gene (GNE), which results in reduced enzyme function and sialic acid levels. A majority of individuals with HIBM2 are from Iranian-Jewish or Japanese decent, but isolated cases have been identified world wide. This article reviews the diagnostic criteria for HIBM2. Current research with a highlight on the biology of the disease and the role of GNE in the sialic acid pathway are assessed. Finally, therapeutic investigations and animal models are discussed with a focus on future studies to better understand the pathology of Hereditary Inclusion Body Myopathy and move therapeutic agents towards clinical trials.
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6
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Chu CC, Kuo HC, Yeh TH, Ro LS, Chen SR, Huang CC. Heterozygous mutations affecting the epimerase domain of the GNE gene causing distal myopathy with rimmed vacuoles in a Taiwanese family. Clin Neurol Neurosurg 2006; 109:250-6. [PMID: 17098358 DOI: 10.1016/j.clineuro.2006.09.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2006] [Revised: 09/25/2006] [Accepted: 09/28/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Studies of distal myopathy with rimmed vacuoles (DMRV) revealed that most patients had mutations in the UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase (GNE) gene. However, the correlation between GNE mutations and clinical features was not fully understood. PURPOSES To report the correlation between the clinical features and genetic analysis of DMRV patients. PATIENTS AND METHODS The clinical presentations, histopathological findings, image studies, and genetic analyses of two patients with DMRV from a Taiwanese family were studied. RESULTS Two compound heterozygous mutations, Ile 241 Ser and Arg 246 Gln, located in the epimerase domain, were identified in both patients, who were of the same generation. In addition, the elder sister showed a progressive muscular dystrophy course with severe quadriceps and trunk muscle involvement. CONCLUSION The compound heterozygous mutations in the epimerase domain of the GNE gene are important in the severe phenotype of DMRV. However, the mechanisms leading to this phenotypic heterogeneity still remain to be elucidated.
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Affiliation(s)
- Chun-Che Chu
- Department of Neurology, Chang Gung Memorial Hospital and University, 199 Tung-Hwa North Road, Taipei, Taiwan
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7
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Toriumi Y, Takusa Y, Uchiyama A, Kimura M, Sejima H, Yamaguchi S, Eda I, Nishino I, Nonaka I. Distal myopathy with rimmed vacuoles in a case of opercular syndrome. Brain Dev 2006; 28:458-61. [PMID: 16503389 DOI: 10.1016/j.braindev.2005.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2005] [Revised: 12/06/2005] [Accepted: 12/06/2005] [Indexed: 10/25/2022]
Abstract
We report the case of a 30-year-old man with opercular syndrome who developed distal myopathy with rimmed vacuoles (DMRV). Muscle biopsy showed variation in fiber size and scattered fibers with rimmed vacuoles. The identification of a homozygous c. 1714G>C (p. V572L) mutation in the GNE gene genetically confirmed the diagnosis of DMRV, which is thought to be identical to hereditary inclusion body myopathy (HIBM). Our results indicate the possibility that other organs such as the central nervous system could be affected in DMRV/HIBM, although bilateral opercular lesions might have been caused by destructive events either in utero or in the perinatal period.
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Affiliation(s)
- Yoshitaka Toriumi
- Department of Pediatrics, Shimane University School of Medicine, Izumo 693-8501, Japan.
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8
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Merkli H, Pál E, Gáti I, Czopf J. Distal myopathy with rimmed vacuoles and cerebellar atrophy. Pathol Oncol Res 2006; 12:115-7. [PMID: 16799715 DOI: 10.1007/bf02893456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2005] [Accepted: 02/21/2006] [Indexed: 11/30/2022]
Abstract
Distal myopathies constitute a clinically and pathologically heterogeneous group of genetically determined neuromuscular disorders, where the distal muscles of the upper or lower limbs are affected. The disease of a 41-year-old male patient started with gait disturbances, when he was 25. The progression was slow, but after 16 years he became seriously disabled. Neurological examination showed moderate to severe weakness in distal muscles of all extremities, marked cerebellar sign and steppage gait. Muscle biopsy resulted in myopathic changes with rimmed vacuoles. Brain MRI scan showed cerebellar atrophy. This case demonstrates a rare association of distal myopathy and cerebellar atrophy.
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Affiliation(s)
- Hajnalka Merkli
- Department of Neurology, Faculty of Medicine, University of Pécs, Pécs, H-7623, Hungary
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9
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Tomimitsu H, Shimizu J, Ishikawa K, Ohkoshi N, Kanazawa I, Mizusawa H. Distal myopathy with rimmed vacuoles (DMRV): new GNE mutations and splice variant. Neurology 2004; 62:1607-10. [PMID: 15136692 DOI: 10.1212/01.wnl.0000123115.23652.6c] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Study of the UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase gene (GNE) revealed that almost all cases of distal myopathy with rimmed vacuoles were caused by GNE mutations. Seven new mutations were identified, including M712T, which is the most common mutation in Jewish hereditary inclusion body myopathy. In addition, a splice-variant characteristic of the skeletal muscle was found, whereas the difference of the expression level between GNE-mutated and -nonmutated patients was not apparent.
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Affiliation(s)
- H Tomimitsu
- Department of Neurology and Neurological Science, Graduate School, Tokyo Medical and Dental University, University of Tokyo, Japan
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10
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Arai A, Tanaka K, Ikeuchi T, Igarashi S, Kobayashi H, Asaka T, Date H, Saito M, Tanaka H, Kawasaki S, Uyama E, Mizusawa H, Fukuhara N, Tsuji S. A novel mutation in the GNE gene and a linkage disequilibrium in Japanese pedigrees. Ann Neurol 2002; 52:516-9. [PMID: 12325084 DOI: 10.1002/ana.10341] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Distal myopathy with rimmed vacuoles (DMRV) is an autosomal recessive muscular disorder characterized by weakness of the anterior compartment of the lower limbs with onset in early adulthood and sparing of the quadricep muscles. The UDP-N-acetylglucosamine-2-epimerase/N-acetylmannosamine kinase (GNE) gene was recently identified as the causative gene for hereditary inclusion body myopathy (HIBM). To investigate whether DMRV and HIBM are allelic diseases, we conducted mutational analysis of the GNE gene of six Japanese DMRV pedigrees and found that all the pedigrees share a homozygous mutation (V572L) associated with a strong linkage disequilibrium, suggesting a strong founder effect in Japanese DMRV pedigrees.
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Affiliation(s)
- Aki Arai
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
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11
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Simmons Z, Towfighi J. Sporadic inclusion body myositis and hereditary inclusion body myopathy. J Clin Neuromuscul Dis 2002; 3:122-132. [PMID: 19078666 DOI: 10.1097/00131402-200203000-00005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Sporadic inclusion body myositis (s-IBM) is a common but under-recognized myopathy in individuals over 50 years of age. An awareness of the clinical phenotype and of the electrodiagnostic and histopathologic features should lead to improved recognition, and should minimize confusion with polymyositis, motor neuron disease, and other neuromuscular disorders. Treatment efficacy has been difficult to judge because of the insidious progression of the disease over many years, but immunomodulating therapy is generally less effective than in polymyositis and dermatomyositis, and may not be effective at all in many patients. The hereditary inclusion body myopathies (h-IBM) are a heterogeneous group of recessively and dominantly inherited vacuolar myopathies that share some histologic features with s-IBM. Oxidative stress may play a role in the pathogenesis of both s-IBM and h-IBM.
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Affiliation(s)
- Zachary Simmons
- Salt Lake City, UT From the *Division of Neurology and the daggerDepartment of Pathology, Penn State College of Medicine, Hershey, Pennsylvania
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12
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Abstract
Although most muscle disorders produce proximal weakness, some myopathies may manifest predominantly or exclusively distal weakness. Although several congenital, inflammatory, or metabolic myopathies may produce mainly distal weakness, there are several distinct entities, typically referred to as distal myopathies. Most of these are inherited conditions. The distal myopathies are rare, but characteristic clinical and histological features aid in their identification. Advances in molecular genetics have led to the identification of the gene lesions responsible for several of these entities and have also expanded our understanding of the genetic relationships of distal myopathies to other inherited disorders of muscle. This review summarizes current knowledge of the clinical and molecular aspects of the distal myopathies.
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Affiliation(s)
- D S Saperstein
- Department of Neurology, Wilford Hall Medical Center, 2200 Bergquist Drive, Suite 1 (MMCNN), San Antonio, Texas 78236-5300, USA.
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13
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Barohn RJ, Amato AA, Griggs RC. Overview of distal myopathies: from the clinical to the molecular. Neuromuscul Disord 1998; 8:309-16. [PMID: 9673984 DOI: 10.1016/s0960-8966(98)00030-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Five distinct predominantly distal myopathies have been identified with discrete clinical and genetic patterns as follows: (1) Welander myopathy (late adult onset, type 1), with autosomal dominant inheritance and unknown molecular localization; (2) Markesbery-Griggs/Udd myopathies (late adult onset, type 2), with autosomal dominant inheritance and linkage to chromosome 2q; (3) Nonaka myopathy (early adult onset, type 1), with autosomal recessive inheritance and molecular localization to 9p1-q1. Nonaka myopathy is identical to quadriceps-sparing familial inclusion body myopathy; (4) Miyoshi myopathy (early adult onset, type 2), with autosomal recessive inheritance and localization to 2p; (5) Laing myopathy (early onset, type 3), with autosomal dominant inheritance and linkage to chromosome 14. The gene and abnormal gene product have not yet been defined for any of the distal myopathies. However, it is already clear that disorders allelic to the distal myopathies can begin with proximal weakness. Given such major phenotypic variation, it is possible that some of the diseases we regard as distal myopathies may become obsolete. Instead, these conditions may become known by their genetic mutation or abnormal gene product, much like Duchenne and Becker dystrophy.
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Affiliation(s)
- R J Barohn
- Department of Neurology, University of Texas Southwestern Medical Center at Dallas 75235-8897, USA
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14
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Abstract
Distal myopathy with rimmed vacuoles is an autosomal recessively inherited disorder with preferential involvement of the anterior tibial muscle. Recently the gene was discovered to be mapped to chromosome 9, the same region as in familial inclusion body myopathy (rimmed vacuole myopathy sparing the quadriceps). The onset of the disease was in young adults 20-40 years of age, averaging 26 years. The disease was progressive and most of the patients became non-ambulant within 12 years after the onset. The striking and common pathologic finding was the presence of rimmed vacuoles in muscle fibers with little evidence of necrotic or regenerative processes. Nuclear change with tubulofilamentous inclusions probably induces focal myofibrillar degeneration which activates the lysosomal system, resulting in active autophagocytosis and myelin body formation, i.e. rimmed vacuole formation.
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Affiliation(s)
- I Nonaka
- National Center of Neurology and Psychiatry, Tokyo, Japan.
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Ikeuchi T, Asaka T, Saito M, Tanaka H, Higuchi S, Tanaka K, Saida K, Uyama E, Mizusawa H, Fukuhara N, Nonaka I, Takamori M, Tsuji S. Gene locus for autosomal recessive distal myopathy with rimmed vacuoles maps to chromosome 9. Ann Neurol 1997; 41:432-7. [PMID: 9124799 DOI: 10.1002/ana.410410405] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Distal myopathy with rimmed vacuoles is an autosomal recessive muscular disorder, characterized clinically by weakness of the distal muscles in the lower limbs in early adulthood. Recently, the gene locus for familial vacuolar myopathy with autosomal recessive inheritance (hereditary inclusion body myopathy) was mapped to chromosome 9 by genome-wide linkage analysis of nine Persian-Jewish families. Since both disease conditions share similar clinical, genetic, and histopathological features, we analyzed seven families with distal myopathy with rimmed vacuoles using ten microsatellite markers within the region of the hereditary inclusion body myopathy locus. Significantly high cumulative pairwise lod scores were obtained with three markers: D9S248 (Z(max) = 5.90 at theta = 0), D9S43 (Z(max) = 5.25 at theta = 0), and D9S50 (Z(max) = 4.23 at theta = 0). Detection of obligate recombination events as well as multipoint linkage analysis revealed that the most likely location of the distal myopathy with rimmed vacuoles gene is in a 23.3-cM interval defined by D9S319 and D9S276 on chromosome 9. The results raise the possibility that distal myopathy with rimmed vacuoles and hereditary inclusion body myopathy in Persian Jews are allelic diseases.
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Affiliation(s)
- T Ikeuchi
- Department of Neurology, Niigata University, Asahimachi, Japan
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Partanen J, Laulumaa V, Paljärvi L, Partanen K, Naukkarinen A. Late onset foot-drop muscular dystrophy with rimmed vacuoles. J Neurol Sci 1994; 125:158-67. [PMID: 7807161 DOI: 10.1016/0022-510x(94)90029-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We studied a family with late-onset (fifth or sixth decade) or asymptomatic hereditary myopathy of the anterior tibial muscle. The occurrence of the disease in two successive generations pointed out an autosomal dominant pattern of inheritance. The initial symptom was uni- or bilateral foot drop resembling peroneal paresis. Surprisingly many of the diagnosed patients were asymptomatic and considered themselves healthy whether there was any foot drop or not. The anterior tibial muscles were atrophic in patients with foot drop but the long toe extensors were usually and the short ones were always spared. Apparently the toe extensors could relieve the foot drop symptom. As shown by computed tomography there was often an early uni- or bilateral involvement of the semimembranosus muscle in males. The proband showed also a late involvement of the femoral biceps and the minor gluteal muscles. The muscles of the upper extremity were spared. The anterior tibial muscles had a characteristic myopathic alteration with rimmed vacuoles in histopathological study. This picture was most evident in latent cases without atrophy of the anterior tibial muscle, but with distinctly abnormal EMG of that muscle. Non-affected muscles showed only slight non-specific histopathological changes. We suggest that this disease is a new mild variety of autosomal dominant distal myopathy with rimmed vacuoles.
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Affiliation(s)
- J Partanen
- Department of Clinical Neurophysiology, University Hospital of Kuopio, Finland
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17
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Helliwell TR, Green AR, Green A, Edwards RH. Hereditary distal myopathy with granulo-filamentous cytoplasmic inclusions containing desmin, dystrophin and vimentin. J Neurol Sci 1994; 124:174-87. [PMID: 7964869 DOI: 10.1016/0022-510x(94)90324-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A 56-year-old female and her 34-year-old daughter presented with a predominantly distal myopathy affecting the peroneal and calf muscles, neck flexors and hand muscles. Both patients and two other daughters had cardiac arrhythmias, three requiring the insertion of cardiac pacemakers. Skeletal muscle biopsies revealed a complex myopathic process with granular degeneration, rimmed vacuoles and eosinophilic cytoplasmic inclusions. Ultrastructurally, the inclusions were composed of electron dense granular material and filaments forming linear masses beneath the sarcolemma and rounded masses within the cytoplasm of the fibres. Immunohistochemistry revealed labelling of the inclusions for desmin, dystrophin and vimentin, but not for alpha-actinin, spectrin, utrophin or myosin heavy chains. This family shows a hereditary distal myopathy with some features in common with previously-reported cases in which biopsies showed cytoplasmic inclusion bodies containing desmin. This group of diseases is clinically and pathologically heterogeneous. In the present cases, the accumulation of cytoplasmic filaments may reflect a generalised disturbance of filamentous protein metabolism rather than a specific disorder of desmin.
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Affiliation(s)
- T R Helliwell
- Department of Pathology, University of Liverpool, UK
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Kalimo H, Savontaus ML, Lang H, Paljärvi L, Sonninen V, Dean PB, Katevuo K, Salminen A. X-linked myopathy with excessive autophagy: a new hereditary muscle disease. Ann Neurol 1988; 23:258-65. [PMID: 2897824 DOI: 10.1002/ana.410230308] [Citation(s) in RCA: 76] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We report on 3 brothers with a myopathy that also affected their maternal grandfather and great-uncle. Characteristic features are onset in early childhood, very slow progression, normal life expectancy, weakness of proximal limb muscles, especially in the legs, elevation of serum creatine kinase, and no cardiac or intellectual involvement. In biopsy material muscle fibers are almost never necrotic but show excessive autophagic activity and exocytosis of the phagocytosed material. We suggest that this family has an undescribed type of congenital myopathy, for which we propose the name X-linked myopathy with excessive autophagy.
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Affiliation(s)
- H Kalimo
- Department of Pathology, University of Turku, Finland
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Mizusawa H, Kurisaki H, Takatsu M, Inoue K, Mannen T, Toyokura Y, Nakanishi T. Rimmed vacuolar distal myopathy. An ultrastructural study. J Neurol 1987; 234:137-45. [PMID: 3585420 DOI: 10.1007/bf00314132] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
An ultrastructural study of biopsied muscles was performed in seven patients with rimmed vacuolar distal myopathy, which was characterized by prominent rimmed vacuoles in the muscle fibers. The earliest changes noted were focal proliferation of the Golgi's apparatus and mitochondrial degeneration with myofibrillar loss. A proliferation of the T-system appeared later. Secondary lysosomes (autophagosomes) could be noted much later and gradually increased in number. Autophagosomes tended to coalesce and became larger autophagic vacuoles, which were surrounded in part by relatively preserved myofibrils and partly by a single membrane. Gently curved laminated structures (tubulomembranous structures) were seen in the degenerating muscle fibers and also in relatively intact fibers, satellite cells, and interstitial cells in all cases. They were closely associated with lipofuscin-like material. These findings suggest that an abnormality of the lysosomal system might be essential in the pathogenesis of rimmed vacuolar distal myopathy.
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