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Wen B, Tang R, Tang S, Sun Y, Xu J, Zhao D, Wang T, Yan C. A comparative study on riboflavin responsive multiple acyl-CoA dehydrogenation deficiency due to variants in FLAD1 and ETFDH gene. J Hum Genet 2024; 69:125-131. [PMID: 38228875 DOI: 10.1038/s10038-023-01216-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 12/02/2023] [Accepted: 12/13/2023] [Indexed: 01/18/2024]
Abstract
Lipid storage myopathy (LSM) is a heterogeneous group of lipid metabolism disorders predominantly affecting skeletal muscle by triglyceride accumulation in muscle fibers. Riboflavin therapy has been shown to ameliorate symptoms in some LSM patients who are essentially concerned with multiple acyl-CoA dehydrogenation deficiency (MADD). It is proved that riboflavin responsive LSM caused by MADD is mainly due to ETFDH gene variant (ETFDH-RRMADD). We described here a case with riboflavin responsive LSM and MADD resulting from FLAD1 gene variants (c.1588 C > T p.Arg530Cys and c.1589 G > C p.Arg530Pro, FLAD1-RRMADD). And we compared our patient together with 9 FLAD1-RRMADD cases from literature to 106 ETFDH-RRMADD cases in our neuromuscular center on clinical history, laboratory investigations and pathological features. Furthermore, the transcriptomics study on FLAD1-RRMADD and ETFDH-RRMADD were carried out. On muscle pathology, both FLAD1-RRMADD and ETFDH-RRMADD were proved with lipid storage myopathy in which atypical ragged red fibers were more frequent in ETFDH-RRMADD, while fibers with faint COX staining were more common in FLAD1-RRMADD. Molecular study revealed that the expression of GDF15 gene in muscle and GDF15 protein in both serum and muscle was significantly increased in FLAD1-RRMADD and ETFDH-RRMADD groups. Our data revealed that FLAD1-RRMADD (p.Arg530) has similar clinical, biochemical, and fatty acid metabolism changes to ETFDH-RRMADD except for muscle pathological features.
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Affiliation(s)
- Bing Wen
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Runqi Tang
- Department of Pathology, Maternal and Child Health Hospital of Liaocheng, Liaocheng, 252000, Shandong, China
| | - Shuyao Tang
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Yuan Sun
- Department of Neurology, Qilu Hospital (Qingdao), Shandong University, Qingdao, 266035, Shandong, China
| | - Jingwen Xu
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Dandan Zhao
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Tan Wang
- Department of Geriatric Medicine, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China.
| | - Chuanzhu Yan
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China.
- Brain Science Research Institute, Shandong University, Jinan, 250012, Shandong, China.
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McKenzie CM, Marinkovich M, Armién AG, Leger JS, Armando AM, Dennis EA, Quehenberger O, Righton A. Lipid storage disease in 4 sibling superb birds-of-paradise ( Lophorina superba). Vet Pathol 2024; 61:288-297. [PMID: 37842940 PMCID: PMC11032166 DOI: 10.1177/03009858231203314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Pedigree analysis, clinical, gross, microscopic, ultrastructural, and lipidomic findings in 4 female superb bird-of-paradise (SBOP, Lophorina superba) siblings led to the diagnosis of a primary inherited glycerolipid storage disease. These birds were the offspring of a related breeding pair (inbreeding coefficient = 0.1797) and are the only known SBOPs to display this constellation of lesions. The birds ranged from 0.75 to 4.3 years of age at the time of death. Two birds were euthanized and 1 died naturally due to the disease, and 1 died of head trauma with no prior clinical signs. Macroscopic findings included hepatomegaly and pallor (4/4), cardiac and renal pallor (2/4), and coelomic effusion (1/4). Microscopic examination found marked tissue distortion due to cytoplasmic lipid vacuoles in hepatocytes (4/4), cardiomyocytes (4/4), renal tubular epithelial cells (4/4), parathyroid gland principal cells (2/2), exocrine pancreatic cells (3/3), and the glandular cells of the ventriculus and proventriculus (3/3). Ultrastructurally, the lipids were deposited in single to coalescing or fused droplets lined by an inconspicuous or discontinuous monolayer membrane. Lipidomic profiling found that the cytoplasmic lipid deposits were primarily composed of triacylglycerols. Future work, including sequencing of the SBOP genome and genotyping, will be required to definitively determine the underlying genetic mechanism of this disease.
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Ma J, Zhang H, Liang F, Li G, Pang X, Zhao R, Wang J, Chang X, Guo J, Zhang W. The male-to-female ratio in late-onset multiple acyl-CoA dehydrogenase deficiency: a systematic review and meta-analysis. Orphanet J Rare Dis 2024; 19:72. [PMID: 38365830 PMCID: PMC10873946 DOI: 10.1186/s13023-024-03072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/03/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) is the most common lipid storage myopathy. There are sex differences in fat metabolism and it is not known whether late-onset MADD affects men and women equally. METHODS In this systematic review and meta-analysis, the PubMed, Embase, Web of Science, CNKI, CBM, and Wanfang databases were searched until 01/08/2023. Studies reporting sex distribution in patients with late-onset MADD were included. Two authors independently screened studies for eligibility, extracted data, and assessed risk of bias. Pre-specified outcomes of interest were the male-to-female ratio (MFR) of patients with late-onset MADD, the differences of clinical characteristics between the sexes, and factors influencing the MFR. RESULTS Of 3379 identified studies, 34 met inclusion criteria, yielding a total of 609 late-onset MADD patients. The overall pooled percentage of males was 58% (95% CI, 54-63%) with low heterogeneity across studies (I2 = 2.99%; P = 0.42). The mean onset ages, diagnostic delay, serum creatine kinase (CK), and allelic frequencies of 3 hotspot variants in ETFDH gene were similar between male and female patients (P > 0.05). Meta-regressions revealed that ethnic group was associated with the MFR in late-onset MADD, and subgroup meta-analyses demonstrated that East-Asian patients had a higher percentage of male, lower CK, and higher proportion of hotspot variants in ETFDH gene than non-East-Asian patients (P < 0.05). CONCLUSIONS Male patients with late-onset MADD were more common than female patients. Ethnicity was proved to be a factor influencing the MFR in late-onset MADD. These findings suggest that male sex may be a risk factor for the disease.
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Affiliation(s)
- Jing Ma
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Huiqiu Zhang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Feng Liang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Guanxi Li
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Xiaomin Pang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
| | - Rongjuan Zhao
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
| | - Juan Wang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
| | - Xueli Chang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China
| | - Junhong Guo
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China.
| | - Wei Zhang
- Department of Neurology, First Hospital, Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China.
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Xie HP, Zeng WJ, Chen LX, Xie ZX, Wang XP, Zhao S. Cardiogenic shock and asphyxial cardiac arrest due to glutaric aciduria type II. World J Emerg Med 2023; 14:72-74. [PMID: 36713348 PMCID: PMC9842470 DOI: 10.5847/wjem.j.1920-8642.2023.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/02/2022] [Indexed: 02/01/2023] Open
Affiliation(s)
- Hai-ping Xie
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China,Department of Emergency, Fujian Provincial Hospital, Fuzhou 350001, China
| | - Wei-jia Zeng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China,Department of Emergency, Fujian Provincial Hospital, Fuzhou 350001, China,Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou 350001, China
| | - Li-xun Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China,Department of Emergency, Fujian Provincial Hospital, Fuzhou 350001, China,Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou 350001, China
| | - Zhang-xin Xie
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China,Department of Emergency, Fujian Provincial Hospital, Fuzhou 350001, China,Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou 350001, China
| | - Xiao-ping Wang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China,Department of Emergency, Fujian Provincial Hospital, Fuzhou 350001, China,Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou 350001, China,Xiao-ping Wang,
| | - Shen Zhao
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China,Corresponding Authors: Shen Zhao, ;
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Paul P, Vazquez Do Campo R, Liewluck T, Naddaf E. Ranolazine-induced lipid storage myopathy presenting with respiratory failure and head drop. Neuromuscul Disord 2021; 31:546-550. [PMID: 33903020 DOI: 10.1016/j.nmd.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/17/2022]
Abstract
Ranolazine is an anti-ischemic drug often used along with statins in patients with ischemic heart disease. Ranolazine-induced proximal myopathy or rhabdomyolysis have been rarely reported, but toxic effects of statins could not be completely ruled out in those cases. We report a 68-year-old man with ranolazine-induced myopathy who presented with respiratory insufficiency and head drop. Creatine kinase level was normal. The Patient continued to worsen despite statin cessation but markedly improved after stopping ranolazine. Muscle biopsy showed excessive lipid accumulation predominantly in type 1 myofibers. The precise mechanism of toxicity is not clear. Treating physicians should be aware of this rare but potentially debilitating adverse effect of ranolazine. Prognosis is good upon discontinuation of the offending drug.
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Affiliation(s)
- Pritikanta Paul
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, United States; Department of Neurology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, United States
| | - Rocio Vazquez Do Campo
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States; Department of Neurology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, United States
| | - Teerin Liewluck
- Department of Neurology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, United States
| | - Elie Naddaf
- Department of Neurology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, United States.
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Shi J, Qu Q, Liu H, Zhang Y, Cui W, Chen P, Lv H. Case Report: PNPLA2 Gene Complex Heterozygous Mutation Leading to Neutral Lipid Storage Disease With Myopathy. Front Integr Neurosci 2021; 14:554724. [PMID: 33551761 PMCID: PMC7862117 DOI: 10.3389/fnint.2020.554724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 12/16/2020] [Indexed: 12/29/2022] Open
Abstract
Objective: To investigate the clinical features, skeletal muscle imaging, muscle pathology, blood smear and so on of neutral lipid storage disease with myopathy (NLSDM) caused by PNPLA2 gene mutation. Methods: The clinical data, skeletal muscle imaging, pathological data, and genetic test results of a patient with NLSDM treated in our hospital were collected in detail, and the previous literature was reviewed and compared. Results: The main symptoms were muscle weakness and muscular atrophy. Pathological findings of muscle biopsy showed fat deposition in muscle fibers with border cavitation. Fatty droplets were seen in the cytoplasm of neutrophils in peripheral blood. Magnetic resonance imaging of the muscles of both lower extremities showed that muscle in the thigh vastus intermedius, lateral muscles, biceps, and the muscle abdominal area of the middle leg were filled or replaced by fat. Genetic test results suggested mutations in the PNPLA2 gene. Conclusion: NLSDM is a rare clinical myopathy with abnormal lipid metabolism. Characteristic changes can be seen in skeletal muscle imaging and pathology. The detection of PNPLA2 gene mutation is an important basis for diagnosing NLSDM. Asymmetry and progressive limb weakness are the clinical features. Muscle MRI is mainly involved in the posterior group of the lower limbs. Jordans bodies in the peripheral blood smear and a large number of coarse-grained lipid deposits with rimmed vacuoles in muscle fibers are the characteristic pathological changes.
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Affiliation(s)
- Jiejing Shi
- Department of Neurology, Jiaozuo People's Hospital, Jiaozuo, China
| | - Qianqian Qu
- Department of Neurology, Jiaozuo People's Hospital, Jiaozuo, China
| | - Haiyan Liu
- Department of Neurology, Jiaozuo People's Hospital, Jiaozuo, China
| | - Yan Zhang
- Department of Neurology, Jiaozuo People's Hospital, Jiaozuo, China
| | - Wenhao Cui
- Jiaozuo People's Hospital Affiliated to Xinxiang Medical College, Xinxiang, China
| | - Ping Chen
- Jiaozuo People's Hospital Affiliated to Xinxiang Medical College, Xinxiang, China
| | - Haidong Lv
- Department of Neurology, Jiaozuo People's Hospital, Jiaozuo, China
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Nix JS, Moore SA. What Every Neuropathologist Needs to Know: The Muscle Biopsy. J Neuropathol Exp Neurol 2020; 79:719-733. [PMID: 32529201 PMCID: PMC7304986 DOI: 10.1093/jnen/nlaa046] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/18/2020] [Accepted: 04/28/2020] [Indexed: 12/17/2022] Open
Abstract
Competence in muscle biopsy evaluation is a core component of neuropathology practice. The practicing neuropathologist should be able to prepare frozen sections of muscle biopsies with minimal artifacts and identify key histopathologic features of neuromuscular disease in hematoxylin and eosin-stained sections as well as implement and interpret a basic panel of additional histochemical, enzyme histochemical, and immunohistochemical stains. Important to everyday practice is a working knowledge of normal muscle histology at different ages, muscle motor units, pitfalls of myotendinous junctions, nonpathologic variations encountered at traditional and nontraditional muscle sites, the pathophysiology of myonecrosis and regeneration, and approaches to distinguish muscular dystrophies from inflammatory myopathies and other necrotizing myopathies. Here, we provide a brief overview of what every neuropathologist needs to know concerning the muscle biopsy.
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Affiliation(s)
- James S Nix
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Steven A Moore
- Department of Pathology, Carver College of Medicine, The University of Iowa, Iowa City, Iowa
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8
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18F-FDG muscular superscan associated with lipid storage myopathy. Eur J Nucl Med Mol Imaging 2020; 47:2932-2933. [PMID: 32232519 DOI: 10.1007/s00259-020-04775-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 03/12/2020] [Indexed: 10/24/2022]
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9
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Needle EMG, a Jigsaw to Disclose Lipid Storage Myopathy Due to Multiple Acyl-CoA Dehydrogenase Deficiency. Am J Phys Med Rehabil 2020; 99:e71-e74. [PMID: 31136308 DOI: 10.1097/phm.0000000000001230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Multiple acyl-CoA dehydrogenase deficiency is a rare autosomal recessive inborn error of metabolism. The late-onset multiple acyl-CoA dehydrogenase deficiency is frequently caused by mutations in ETFDH gene. Because of its clinical heterogeneity, diagnosis and treatment of late-onset multiple acyl-CoA dehydrogenase deficiency are often delayed. The authors described a previously healthy 40-yr-old Thai woman presenting with subacute severe weakness of bulbar-limb muscles and elevated serum creatine kinase. The authors emphasized the importance of needle EMG and prompt muscle histopathological evaluation, which rapidly led to the diagnosis and riboflavin therapy, resulting in a dramatic and rapid improvement before genetic study disclosed mutation in ETFDH gene.
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Huang K, Duan HQ, Li QX, Luo YB, Yang H. Investigation of adult-onset multiple acyl-CoA dehydrogenase deficiency associated with peripheral neuropathy. Neuropathology 2020; 40:531-539. [PMID: 32608139 DOI: 10.1111/neup.12667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 01/03/2023]
Abstract
Multiple Acyl-CoA dehydrogenase deficiency (MADD), one of the most common lipid storage myopathies (LSMs), is a heterogeneous inherited muscular disorder that is pathologically characterized by numerous lipid droplets in muscle fibers due to lipid metabolism disturbance. MADD exhibits a wide range of clinical features, including skeletal muscle weakness and multisystem dysfunctions. However, MADD, as well as other types of LSM, associated with peripheral neuropathy has rarely been reported during the past four decades. Here, we present four Chinese patients affected by MADD with peripheral neuropathy in our neuromuscular center. Clinically, these four patients showed skeletal muscle weakness and prominent paresthesia. Muscle biopsy detected characteristic myopathological patterns of LSM, such as obvious lipid droplets in muscle fibers. Sural nerve biopsy revealed a severe reduction in number of myelinated nerve fibers, which is a typical neuropathological pattern of peripheral neuropathy. Causative ETFDH mutations were found in all four cases. The skeletal muscle weakness was rapidly improved after some treatments while paresthesia showed unsatisfactory improvement. The features of previously reported patients of this specific type are also summarized in this paper. We propose that MADD with peripheral neuropathy may be a new phenotypic subtype because the pathology and reaction to riboflavin treatment are different from those of traditional MADD, although further research on the precise pathogenesis and mechanisms is needed.
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Affiliation(s)
- Kun Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hui-Qian Duan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qiu-Xiang Li
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yue-Bei Luo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Huan Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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Chinen Y, Yanagi K, Nakamura S, Nakayama N, Kamiya M, Nakayashiro M, Kaname T, Naritomi K, Nakanishi K. A novel homozygous missense SLC25A20 mutation in three CACT-deficient patients: clinical and autopsy data. Hum Genome Var 2020; 7:11. [PMID: 32337051 PMCID: PMC7162975 DOI: 10.1038/s41439-020-0098-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 12/12/2022] Open
Abstract
Carnitine-acylcarnitine translocase (CACT) deficiency is a fatty acid ß-oxidation disorder of the carnitine shuttle in mitochondria, with a high mortality rate in childhood. We evaluated three patients, including two siblings, with neonatal-onset CACT deficiency and revealed identical homozygous missense mutations of p.Arg275Gln within the SLC25A20 gene. One patient died from hypoglycemia and arrhythmia at 26 months; his pathological autopsy revealed increased and enlarged mitochondria in the heart but not in the liver.
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Affiliation(s)
- Yasutsugu Chinen
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa Japan
- Genetic Counseling Room, University of the Ryukyus Hospital, Nishihara, Okinawa Japan
| | - Kumiko Yanagi
- Department of Genome Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Sadao Nakamura
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa Japan
| | - Noriko Nakayama
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa Japan
| | - Motoko Kamiya
- Department of Pediatrics, Naha City Hospital, Naha, Okinawa Japan
- Present Address: Center for Medical Genetics, Shinshu University Hospital, Matsumoto, Japan
| | - Mami Nakayashiro
- Department of Pediatrics, Okinawa Prefectural Nanbu Medical Center Children’s Medical Center, Haebaru, Okinawa Japan
| | - Tadashi Kaname
- Department of Genome Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kenji Naritomi
- Okinawa Nanbu Habilitation and Medical Center, Naha, Japan
| | - Koichi Nakanishi
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa Japan
- Genetic Counseling Room, University of the Ryukyus Hospital, Nishihara, Okinawa Japan
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12
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Xu H, Chen X, Lian Y, Wang S, Ji T, Zhang L, Li S. Skin damage in a patient with lipid storage myopathy with a novel ETFDH mutation responsive to riboflavin. Int J Neurosci 2020; 130:1192-1198. [PMID: 32064983 DOI: 10.1080/00207454.2020.1730831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Recessive mutations in ETFDH gene have been associated with Multiple Acyl-CoA dehydrogenase deficiency (MADD). The late-onset MADD is often muscle involved, presenting with lipid storage myopathy (LSM). The symptoms of LSM were heterogeneous and definite diagnosis of this disease depends on the pathology and gene test.Methods: Neurological examination, muscle biopsy, and MRI examinations were performed in a patient with a novel missense ETFDH mutation.Results: We describe a patient with lipid storage myopathy complicated with skin damage. In addition, the next generation revealed a novel missense mutation (c.970G > T, p.Val324Leu) in exon 8, which was predicted to be a disease-causing mutation by Mutation-taster, and destroy the function of the protein by Sift.Conclusion: These findings expand the known mutational spectrum of ETFDH and phenotype of MADD.
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Affiliation(s)
- Hongliang Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Xin Chen
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Yajun Lian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Shuya Wang
- Department of Blood Transfusion, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Tuo Ji
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Lu Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Shuang Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
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Nilipour Y, Fatehi F, Sanatinia S, Bradshaw A, Duff J, Lochmüller H, Horvath R, Nafissi S. Multiple acyl-coenzyme A dehydrogenase deficiency shows a possible founder effect and is the most frequent cause of lipid storage myopathy in Iran. J Neurol Sci 2020; 411:116707. [PMID: 32007756 DOI: 10.1016/j.jns.2020.116707] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Multiple acyl-coenzyme A dehydrogenase deficiency disorder (MADD) is a relatively rare disorders of lipid metabolism. This study aimed to investigate the demographic, clinical, and genetic features of MADD in Iran. METHODS Twenty-nine patients with a definite diagnosis of lipid storage myopathy were recruited. All patients were tested for mutation in the ETFDH gene, and 19 had a biallelic mutation in this gene. RESULTS Of 19 patients with definite mutations, 11 (57.9%) were female, and the median age was 31 years. Twelve patients had c.1130 T > C (p.L377P) mutation in exon 10. Two patients had two novel heterozygote pathogenic variants (c.679C > T (p.P227S) in exon 6 and c.814G > A (p.G272R) in exon 7) and two patients had c.1699G > A (p.E567K) in exon 13. Before treatment, the median muscle power was 4.6 (IQR: 4-4.7) that increased to 5 (IQR: 5-5) after treatment (Z = -3.71, p = .000). The median CK was 1848 U/l (IQR: 1014-3473) before treatment, which declined to 188 U/l (IQR: 117-397) after treatment (Z = -3.41, p = .001). Sixteen patients (84.2%) had full recovery after the treatment. The disease onset was earlier (12 years of age; IQR: 6-18) in patients with homozygous c.1130 T > C; p.(L377P) mutation compared to other ETFDH mutations (30 years of age; IQR: 20-35) (p = .00). DISCUSSION MADD has different clinical presentations. As the patients respond favorably to treatment, early diagnosis and treatment may prevent the irreversible complications of the disease.
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Affiliation(s)
- Yalda Nilipour
- Pediatric pathology research center, Research institute for children's health, AND Mofid Children Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Aix Marseille University, CNRS (UMR 7339), Centre de Resonance Magnétique Biologique et Medicale, Faculte de Medecine, 27 bd. J. Moulin, 13005 Marseille, France
| | - Saleheh Sanatinia
- Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anna Bradshaw
- Wellcome Centre for Mitochondrial Research, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Duff
- Wellcome Centre for Mitochondrial Research, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Hanns Lochmüller
- Department of Neuropediatrics and Muscle Disorders, Medical Center - the University of Freiburg, Faculty of Medicine, Freiburg, Germany; Centro Nacional de Análisis Genómico (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain; Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada; Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Canada
| | - Rita Horvath
- Department of Clinical Neurosciences, University of Cambridge School of Clinical Medicine, Cambridge, UK.
| | - Shahriar Nafissi
- Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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14
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Angelini C, Pennisi E, Missaglia S, Tavian D. Metabolic lipid muscle disorders: biomarkers and treatment. Ther Adv Neurol Disord 2019; 12:1756286419843359. [PMID: 31040882 PMCID: PMC6477769 DOI: 10.1177/1756286419843359] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/08/2019] [Indexed: 12/21/2022] Open
Abstract
Lipid storage myopathies (LSMs) are metabolic disorders of the utilization of fat in muscles due to several different defects. In this review, a molecular update of LSMs is presented and recent attempts of finding treatment options are discussed. The main topics discussed are: primary carnitine deficiency, riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency, neutral lipid storage disorders and carnitine palmitoyl transferase deficiency. The most frequent presentations and genetic abnormalities are summarized. We present their diagnosis utilizing biomedical and morphological biomarkers and possible therapeutic interventions. The treatment of these metabolic disorders is a subject of active translational research but appears, in some cases, still elusive.
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Affiliation(s)
- Corrado Angelini
- Fondazione Ospedale San Camillo IRCCS, Via Alberoni 70, Venezia 30126, Italia
| | - Elena Pennisi
- Division of Neurology, S Filippo Neri Hospital, Rome, Italy
| | - Sara Missaglia
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, Milan, Italy Psychology Department, Catholic University of the Sacred Heart, Milan, Italy
| | - Daniela Tavian
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, Milan, Italy Psychology Department, Catholic University of the Sacred Heart, Milan, Italy
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15
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Cai C, Anthony DC, Pytel P. A pattern-based approach to the interpretation of skeletal muscle biopsies. Mod Pathol 2019; 32:462-483. [PMID: 30401945 DOI: 10.1038/s41379-018-0164-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 12/19/2022]
Abstract
The interpretation of muscle biopsies is complex and provides the most useful information when integrated with the clinical presentation of the patient. These biopsies are performed for workup of a wide range of diseases including dystrophies, metabolic diseases, and inflammatory processes. Recent insights have led to changes in the classification of inflammatory myopathies and have changed the role that muscle biopsies have in the workup of inherited diseases. These changes will be reviewed. This review follows a morphology-driven approach by discussing diseases of skeletal muscle based on a few basic patterns that include cases with (1) active myopathic damage and inflammation, (2) active myopathic damage without associated inflammation, (3) chronic myopathic changes, (4) myopathies with distinctive inclusions or vacuoles, (5) biopsies mainly showing atrophic changes, and (6) biopsies that appear normal on routine preparations. Each of these categories goes along with certain diagnostic considerations and pitfalls. Individual biopsy features are only rarely pathognomonic. Establishing a firm diagnosis therefore typically requires integration of all of the biopsy findings and relevant clinical information. With this approach, a muscle biopsy can often provide helpful information in the diagnostic workup of patients presenting with neuromuscular problems.
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Affiliation(s)
- Chunyu Cai
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Douglas C Anthony
- Departments of Pathology and Laboratory Medicine, and Neurology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Peter Pytel
- Department of Pathology, University of Chicago, Chicago, IL, USA.
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16
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Zhou K, Yao P, He J, Zhao H. Lipophagy in nonliver tissues and some related diseases: Pathogenic and therapeutic implications. J Cell Physiol 2018; 234:7938-7947. [PMID: 30537019 DOI: 10.1002/jcp.27988] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 11/21/2018] [Indexed: 12/24/2022]
Abstract
Lipid autophagy (lipophagy) is defined as a selective autophagy process in which some intracellular lipid droplets are selectively degraded by autophagic lysosomes pathway. The occurrence of lipophagy was first discovered in liver tissues. Additionally, abundant evidence indicated that the occurrence of hepatic lipophagy has been implicated in many liver diseases including fatty liver diseases, nonalcoholic fatty liver diseases, liver fibrosis, and liver cirrhosis. However, recent studies suggested that hepatic lipophagy occurs not only in liver tissue but also in other nonliver tissues and cells. Furthermore, the occurrence of lipophagy plays a crucial role in nonliver tissues and some related diseases. For instance, lipophagy relieves insulin resistance in adipose tissue from obesity patient with type 2 diabetes. Additionally, lipophagy has the ability to remit neurodegenerative diseases by reducing activity-dependent neurodegeneration in nervous tissue. Lipophagy decreases muscle lipid accumulation and accordingly improves lipid storage myopathy in muscle tissue. Moreover, lipophagy alleviates the malignancy and metastasis of cancer in clear renal cell carcinoma tissue. Lipophagy is also involved in other processes, such as spermatogenesis, osteoblastogenesis, and mucosal ulceration. In conclusion, targeting lipophagy may be a critical regulator and a new therapeutic strategy for nonliver tissues and some related diseases.
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Affiliation(s)
- Kebing Zhou
- Department of Emergency Medicine, Affiliated Nanhua Hospital, University of South China, Hengyang, China
| | - Pingbo Yao
- Department of Emergency Medicine, Affiliated Nanhua Hospital, University of South China, Hengyang, China
| | - Jun He
- Department of Emergency Medicine, Affiliated Nanhua Hospital, University of South China, Hengyang, China
| | - Hong Zhao
- Department of Basic nursing, Nursing College, University of South China, Hengyang, China
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17
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Differential diagnosis of idiopathic inflammatory myopathies in adults - the first step when approaching a patient with muscle weakness. Reumatologia 2018; 56:307-315. [PMID: 30505013 PMCID: PMC6263305 DOI: 10.5114/reum.2018.79502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/25/2018] [Indexed: 11/17/2022] Open
Abstract
Despite its misleading adjective, the most commonly used diagnostic criteria of idiopathic inflammatory myopathies (IIM) are applicable only after all other non-autoimmune muscle diseases have been excluded. It makes differential diagnosis the first step when approaching a patient with muscle weakness. This article is designed to list the most common conditions from which to differentiate in rheumatological care. In fact, many patients with the diseases described here have been initially misdiagnosed with IIM. For the purpose of this article, only the most commonly found and important conditions according to the authors are listed with the essence of information; other autoimmune muscle diseases, such as sarcoidosis and eosinophilic myositis, are not portrayed. The attached bibliography may serve as a source, when further exploration of a specific subject is needed.
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18
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Garcia MA, Rojas JA, Millán SP, Flórez AA. Neutral lipid storage disease with myopathy and dropped head syndrome. Report of a new variant susceptible of treatment with late diagnosis. J Clin Neurosci 2018; 58:207-209. [DOI: 10.1016/j.jocn.2018.10.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 10/07/2018] [Indexed: 10/28/2022]
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19
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Pennisi EM, Garibaldi M, Antonini G. Lipid Myopathies. J Clin Med 2018; 7:E472. [PMID: 30477112 PMCID: PMC6306737 DOI: 10.3390/jcm7120472] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 11/15/2018] [Accepted: 11/17/2018] [Indexed: 02/06/2023] Open
Abstract
Disorders of lipid metabolism affect several tissues, including skeletal and cardiac muscle tissues. Lipid myopathies (LM) are rare multi-systemic diseases, which most often are due to genetic defects. Clinically, LM can have acute or chronic clinical presentation. Disease onset can occur in all ages, from early stages of life to late-adult onset, showing with a wide spectrum of clinical symptoms. Muscular involvement can be fluctuant or stable and can manifest as fatigue, exercise intolerance and muscular weakness. Muscular atrophy is rarely present. Acute muscular exacerbations, resulting in rhabdomyolysis crisis are triggered by several factors. Several classifications of lipid myopathies have been proposed, based on clinical involvement, biochemical defect or histopathological findings. Herein, we propose a full revision of all the main clinical entities of lipid metabolism disorders with a muscle involvement, also including some those disorders of fatty acid oxidation (FAO) with muscular symptoms not included among previous lipid myopathies classifications.
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Affiliation(s)
- Elena Maria Pennisi
- Unit of Neuromuscular Disorders, Neurology, San Filippo Neri Hospital, 00135 Rome, Italy.
| | - Matteo Garibaldi
- Unit of Neuromuscular Diseases, Department of Neurology, Mental Health and Sensory Organs (NESMOS), SAPIENZA University of Rome, Sant' Andrea Hospital, 00189 Rome, Italy.
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology, Mental Health and Sensory Organs (NESMOS), SAPIENZA University of Rome, Sant' Andrea Hospital, 00189 Rome, Italy.
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20
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Wang J, Wu JC, Yu XE, Han YZ, Yang RM. Long-term outcomes of a patient with late-onset multiple acyl-CoA dehydrogenase deficiency caused by novel mutations in ETFDH: A case report. Medicine (Baltimore) 2018; 97:e13153. [PMID: 30508893 PMCID: PMC6283216 DOI: 10.1097/md.0000000000013153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Late-onset multiple acyl-coenzyme A dehydrogenase deficiency (MADD) mainly affects the neck extensor muscle group, which has been confirmed by novel mutations in electron-transferring-flavoprotein dehydrogenase (ETFDH). So far, a few cases have been reported with long-term follow-up. Here we report a case of late-onset MADD where the patient was followed up for 8 years during which time he underwent 2 muscle biopsies and 2 pathological examinations and his symptoms were significantly alleviated after appropriate treatments. PATIENT CONCERNS In September 2009, a 16-year-old male patient was hospitalized due to gradually increasing difficulty in raising his head and weakness in limb muscles over a 6-month period. During the physical examination, the patient's neck extensor muscle strength was grade III-IV. His proximal limb muscle strength was grade IV, and his distal muscle strength was normal. His blood creatine kinase (CK) was 783 U/L. DIAGNOSIS Muscle biopsy revealed a large number of vacuolar fibers, which were mainly type I fibers. These findings were consistent with the diagnosis of lipid storage myopathy (LSM). ETFDH gene test detected C.736G > A at exon 7 and C.920C > G at exon 8. INTERVENTIONS Coenzyme Q10 treatment was administered. The first coenzyme Q10 40 mg tid was treated for three months, with the change of coenzyme Q10 20 mg tid for 6 months, followed by the change of coenzyme Q10 10 mg tid for long-term use. OUTCOMES The patient's condition significantly improved after 3 months. At 7th year follow-up the patient's blood CK was normal, and a second muscle biopsy revealed no muscle vacuolar fibers and no increase in lipid droplets. Subsequently, the patient was withdrawn from the coenzyme Q10 treatment, and the condition of the patient remained normal. LESSONS Muscle biopsy was the main method used to determine LSM. Treatment with riboflavin should be started when the diagnosis of LSM is definitive. Furthermore, ETFDH gene tests should be performed for further classification. Moreover, coenzyme Q10 may be another effective drug for MADD.
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Affiliation(s)
- Juan Wang
- Department of Neurology, Second People's Hospital of Hefei City
| | - Jun-Cang Wu
- Department of Neurology, Second People's Hospital of Hefei City
| | - Xu-En Yu
- Affiliated Hospital of the Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Yong-Zhu Han
- Affiliated Hospital of the Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Ren-Min Yang
- Affiliated Hospital of the Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
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21
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Vasiljevski ER, Summers MA, Little DG, Schindeler A. Lipid storage myopathies: Current treatments and future directions. Prog Lipid Res 2018; 72:1-17. [PMID: 30099045 DOI: 10.1016/j.plipres.2018.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/20/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
Lipid storage myopathies (LSMs) are a heterogeneous group of genetic disorders that present with abnormal lipid storage in multiple body organs, typically muscle. Patients can clinically present with cardiomyopathy, skeletal muscle weakness, myalgia, and extreme fatigue. An early diagnosis is crucial, as some LSMs can be managed by simple nutraceutical supplementation. For example, high dosage l-carnitine is an effective intervention for patients with Primary Carnitine Deficiency (PCD). This review discusses the clinical features and management practices of PCD as well as Neutral Lipid Storage Disease (NLSD) and Multiple Acyl-CoA Dehydrogenase Deficiency (MADD). We provide a detailed summary of current clinical management strategies, highlighting issues of high-risk contraindicated treatments with case study examples not previously reviewed. Additionally, we outline current preclinical studies providing disease mechanistic insight. Lastly, we propose that a number of other conditions involving lipid metabolic dysfunction that are not classified as LSMs may share common features. These include Neurofibromatosis Type 1 (NF1) and autoimmune myopathies, including Polymyositis (PM), Dermatomyositis (DM), and Inclusion Body Myositis (IBM).
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Affiliation(s)
- Emily R Vasiljevski
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia.; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Matthew A Summers
- Bone Biology Division, The Garvan Institute of Medical Research, Darlinghurst, NSW, Australia; St Vincent's Clinical School, University of New South Wales, Faculty of Medicine, Sydney, NSW, Australia
| | - David G Little
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia.; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Aaron Schindeler
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia.; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia.
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22
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Pinn TL, Divers TJ, Southard T, De Bernardis NP, Wakshlag JJ, Valberg S. Persistent hypoglycemia associated with lipid storage myopathy in a paint foal. J Vet Intern Med 2018; 32:1442-1446. [PMID: 29957835 PMCID: PMC6060329 DOI: 10.1111/jvim.15218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 02/15/2018] [Accepted: 04/24/2018] [Indexed: 11/30/2022] Open
Abstract
A 12‐hours‐old Paint filly was examined because of weakness and dull mentation after birth. Despite IV administered dextrose, the foal remained persistently hypoglycemic with increase in serum activity of muscle and liver enzymes. A postmortem diagnosis of lipid myopathy most similar to multiple acyl‐CoA dehydrogenase deficiency (MADD) was confirmed by findings of myofiber lipid accumulation, elevated urine organic acids, and serum free acylcarnitines with respect to control foals. This report details a case of equine neonatal lipid storage myopathy with many biochemical characteristics of MADD. Lipid storage myopathies should be included as a differential diagnosis in foals with persistent weakness and hypoglycemia.
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Affiliation(s)
- Toby L Pinn
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Thomas J Divers
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Teresa Southard
- Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | | | - Joe J Wakshlag
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Stephanie Valberg
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan
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23
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A Nonsense Variant in the ACADVL Gene in German Hunting Terriers with Exercise Induced Metabolic Myopathy. G3-GENES GENOMES GENETICS 2018; 8:1545-1554. [PMID: 29491033 PMCID: PMC5940147 DOI: 10.1534/g3.118.200084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Several enzymes are involved in fatty acid oxidation, which is a key process in mitochondrial energy production. Inherited defects affecting any step of fatty acid oxidation can result in clinical disease. We present here an extended family of German Hunting Terriers with 10 dogs affected by clinical signs of exercise induced weakness, muscle pain, and suspected rhabdomyolysis. The combination of clinical signs, muscle histopathology and acylcarnitine analysis with an elevated tetradecenoylcarnitine (C14:1) peak suggested a possible diagnosis of acyl-CoA dehydrogenase very long chain deficiency (ACADVLD). Whole genome sequence analysis of one affected dog and 191 controls revealed a nonsense variant in the ACADVL gene encoding acyl-CoA dehydrogenase very long chain, c.1728C>A or p.(Tyr576*). The variant showed perfect association with the phenotype in the 10 affected and more than 500 control dogs of various breeds. Pathogenic variants in the ACADVL gene have been reported in humans with similar myopathic phenotypes. We therefore considered the detected variant to be the most likely candidate causative variant for the observed exercise induced myopathy. To our knowledge, this is the first description of this disease in dogs, which we propose to name exercise induced metabolic myopathy (EIMM), and the identification of the first canine pathogenic ACADVL variant. Our findings provide a large animal model for a known human disease and will enable genetic testing to avoid the unintentional breeding of affected offspring.
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24
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Summers MA, Vasiljevski ER, Mikulec K, Peacock L, Little DG, Schindeler A. Developmental dosing with a MEK inhibitor (PD0325901) rescues myopathic features of the muscle-specific but not limb-specific Nf1 knockout mouse. Mol Genet Metab 2018; 123:518-525. [PMID: 29477258 DOI: 10.1016/j.ymgme.2018.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 12/11/2022]
Abstract
Neurofibromatosis Type 1 (NF1) is a common autosomal dominant genetic disorder While NF1 is primarily associated with predisposition for tumor formation, muscle weakness has emerged as having a significant impact on quality of life. NF1 inactivation is linked with a canonical upregulation Ras-MEK-ERK signaling. This in this study we tested the capacity of the small molecule MEK inhibitor PD0325901 to influence the intramyocellular lipid accumulation associated with NF1 deficiency. Established murine models of tissue specific Nf1 deletion in skeletal muscle (Nf1MyoD-/-) and limb mesenchyme (Nf1Prx1-/-) were tested. Developmental PD0325901 dosing of dams pregnant with Nf1MyoD-/- progeny rescued the phenotype of day 3 pups including body weight and lipid accumulation by Oil Red O staining. In contrast, PD0325901 treatment of 4 week old Nf1Prx1-/- mice for 8 weeks had no impact on body weight, muscle wet weight, activity, or intramyocellular lipid. Examination of day 3 Nf1Prx1-/- pups showed differences between the two tissue-specific knockout strains, with lipid staining greatest in Nf1MyoD-/- mice, and fibrosis higher in Nf1Prx1-/- mice. These data show that a MEK/ERK dependent mechanism underlies NF1 muscle metabolism during development. However, crosstalk from Nf1-deficient non-muscle mesenchymal cells may impact upon muscle metabolism and fibrosis in neonatal and mature myofibers.
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Affiliation(s)
- Matthew A Summers
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Emily R Vasiljevski
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Kathy Mikulec
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Lauren Peacock
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - David G Little
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Aaron Schindeler
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia.
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25
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Tan J, Yang H, Fan J, Fan Y, Xiao F. Patients with neutral lipid storage disease with myopathy (NLSDM) in Southwestern China. Clin Neurol Neurosurg 2018. [PMID: 29539587 DOI: 10.1016/j.clineuro.2018.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Neutral lipid storage disease with myopathy (NLSDM) is a rare metabolic myopathy occurring owing to mutations in the patatin like phospholipase domain containing 2 (PNPLA2) gene. Till date, less than 50 patients with PNPLA2 mutations have been reported. In this study, we describe the clinical, pathological, and genetic findings, and muscle magnetic resonance imaging (MRI) changes in four Chinese patients with NLSDM. PATIENTS AND METHODS Peripheral blood smears were stained using Wright's stain. Muscle biopsies, muscle MRI, and sequence analysis of PNPLA2 gene were performed. RESULTS All patients exhibited slowly progressive myopathy during adulthood. Cardiomyopathy, sensorineural hearing loss, hepatic adipose infiltration, and hypertriglyceridemia were observed in some patients. Jordan's anomaly was detected in the blood smears of all patients. Muscle biopsies revealed the presence of massive lipid droplets and rimmed vacuoles in two patients. MR images of the lower lumbar, pelvis, and lower extremities showed the involvement of posterior compartment muscles. The anterior compartment muscles were found to be less affected. Gene analysis for PNPLA2 revealed an identical homozygous mutation c.757 + 1G > T in all patients. CONCLUSION Patients with NLSDM display clinical heterogeneities despite sharing the same mutation (c.757 + 1G > T) of the PNPLA2 gene, may suggest a founder effect in the region.
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Affiliation(s)
- Jiaze Tan
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing 400016, China
| | - Haitao Yang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jingchuan Fan
- Department of Medical Laboratory Technology, Institute of Life Sciences of Chongqing Medical University, Chongqing 400016, China
| | - Yulan Fan
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing 400016, China
| | - Fei Xiao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing 400016, China.
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26
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Summers MA, Rupasinghe T, Vasiljevski ER, Evesson FJ, Mikulec K, Peacock L, Quinlan KGR, Cooper ST, Roessner U, Stevenson DA, Little DG, Schindeler A. Dietary intervention rescues myopathy associated with neurofibromatosis type 1. Hum Mol Genet 2017; 27:577-588. [DOI: 10.1093/hmg/ddx423] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/29/2017] [Indexed: 02/07/2023] Open
Affiliation(s)
- Matthew A Summers
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | | | - Emily R Vasiljevski
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Frances J Evesson
- Institute for Neuroscience and Muscle Research, The Children’s Hospital Westmead, Sydney, NSW, Australia
| | - Kathy Mikulec
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Lauren Peacock
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Kate G R Quinlan
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
- Institute for Neuroscience and Muscle Research, The Children’s Hospital Westmead, Sydney, NSW, Australia
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, NSW, Australia
| | - Sandra T Cooper
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
- Institute for Neuroscience and Muscle Research, The Children’s Hospital Westmead, Sydney, NSW, Australia
| | - Ute Roessner
- Metabolomics Australia, University of Melbourne, VIC, Australia
| | - David A Stevenson
- Division of Medical Genetics, Stanford University, Stanford, CA, USA
| | - David G Little
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Aaron Schindeler
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
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27
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Angelini C, Tavian D, Missaglia S. Heterogeneous Phenotypes in Lipid Storage Myopathy Due to ETFDH Gene Mutations. JIMD Rep 2017; 38:33-40. [PMID: 28456887 DOI: 10.1007/8904_2017_27] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/06/2017] [Accepted: 04/10/2017] [Indexed: 01/16/2023] Open
Abstract
We present six novel patients affected by lipid storage myopathy (LSM) presenting mutations in the ETFDH gene. Although the diagnosis of multiple acyl-coenzyme-A dehydrogenase deficiency (MADD) in adult life is difficult, it is rewarding because of the possibility of treating patients with carnitine or riboflavin, leading to a full recovery. In our patients, a combination of precipitating risk factors including previous anorexia, alcoholism, poor nutrition, and pregnancy contributed to a metabolic critical condition that precipitated the catabolic state.In the present series of cases, five novel mutations have been identified in the ETFDH gene. We propose clinical guidelines to screen patients with LSM due to different defects, in order to obtain a fast diagnosis and offer appropriate treatment. In such patients, early diagnosis and treatment as well as avoiding risk factors are part of clinical management.Specific biochemical studies are indicated to identify the type of LSM, such as level of free carnitine and acyl-carnitines and studies or organic acidemia. Indeed, when a patient is biochemically diagnosed with secondary carnitine deficiency, a follow-up with appropriate clinical-molecular protocol and genetic analysis is important to establish the final diagnosis, since riboflavin can be supplemented with benefit if riboflavin-responsive MADD is present. In muscle biopsies, increased lipophagy associated with p62-positive aggregates was observed. The clinical improvement can be attributed to the removal of an autophagic block, which appears to be reversible in this LSM.
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Affiliation(s)
| | - Daniela Tavian
- CRIBENS - Laboratory of Cellular Biochemistry and Molecular Biology, Catholic University, Milan, Italy
| | - Sara Missaglia
- CRIBENS - Laboratory of Cellular Biochemistry and Molecular Biology, Catholic University, Milan, Italy
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Parsonage WA, Mikli JE, Nisbet JC, Hamilton-Craig C, Marshall GA. A 61-Year-Old Woman with Muscle Fatigue and Increased Cardiac Troponin. Clin Chem 2017; 63:45-47. [DOI: 10.1373/clinchem.2016.254631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/09/2016] [Indexed: 11/06/2022]
Affiliation(s)
- William A Parsonage
- Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Holy Spirit Northside Hospital, Chermside, Queensland, Australia
| | - Jane E Mikli
- Holy Spirit Northside Hospital, Chermside, Queensland, Australia
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Pathology of muscular steatosis in the bovine species: report of two spontaneously arising cases and comparative overview of the condition. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s00580-016-2376-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Foster LA, Courville EL, Manousakis G. Clinical Reasoning: A 33-year-old man with cardiomyopathy and myopathy. Neurology 2016; 87:e74-8. [PMID: 27550897 DOI: 10.1212/wnl.0000000000002999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Laura A Foster
- From the Departments of Neurology (L.A.F., G.M.) and Clinical Pathology (E.L.C.), University of Minnesota, Minneapolis.
| | - Elizabeth L Courville
- From the Departments of Neurology (L.A.F., G.M.) and Clinical Pathology (E.L.C.), University of Minnesota, Minneapolis
| | - Georgios Manousakis
- From the Departments of Neurology (L.A.F., G.M.) and Clinical Pathology (E.L.C.), University of Minnesota, Minneapolis
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Xu C, Zhao Y, Liu J, Zhang W, Wang Z, Yuan Y. Muscle MRI in neutral lipid storage disease with myopathy carrying mutation c.187+1G>A. Muscle Nerve 2015; 51:922-7. [PMID: 25363365 DOI: 10.1002/mus.24507] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 11/05/2022]
Abstract
INTRODUCTION We describe the clinical and muscle MRI changes in 2 siblings with neutral lipid storage disease with myopathy (NLSDM) carrying the mutation c.187+1G>A. METHODS Peripheral blood smears, genetic tests, and muscle biopsies were performed. Thigh MRI was performed to observe fatty replacement, muscle edema, and muscle bulk from axial sections. RESULTS Both siblings had similar fatty infiltration and edema. T1-weighted images of the gluteus maximus, adductor magnus, semitendinosus, and semimembranosus revealed marked and diffuse fatty infiltration. There was asymmetric involvement in biceps femoris and quadriceps. There was extensive fatty infiltration in the quadriceps, except for the rectus femoris. Gracilis and sartorius were relatively spared. Thigh muscle volume was decreased, while the gracilis and sartorius appeared to show compensatory hypertrophy. CONCLUSIONS Compared with previous reports in NLSDM, MRI changes in this myopathy tended to be more severe. Asymmetry and relatively selective fatty infiltration were characteristics.
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Affiliation(s)
- Chunxiao Xu
- Department of Neurology, Peking University First Hospital, Beijing, 100034, China
| | - Yawen Zhao
- Department of Neurology, Peking University First Hospital, Beijing, 100034, China
| | - Jing Liu
- Department of Neurology, Peking University First Hospital, Beijing, 100034, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, Beijing, 100034, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, Beijing, 100034, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, Beijing, 100034, China
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A case of late-onset riboflavin responsive multiple acyl-CoA dehydrogenase deficiency (MADD) with a novel mutation in ETFDH gene. J Neurol Sci 2015; 353:84-6. [PMID: 25913573 DOI: 10.1016/j.jns.2015.04.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 04/07/2015] [Accepted: 04/10/2015] [Indexed: 11/21/2022]
Abstract
We report a novel mutation in the electron transfer flavoprotein dehydrogenase (EFTDH) gene in an adolescent Chinese patient with late-onset riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency (MADD) characterized by muscle weakness as early symptom. At the age of 9 years, the patient experienced progressive muscle weakness. Blood creatine kinase level and aminotransferase were higher than normal. The muscle biopsy revealed lipid storage myopathy. Serum acylcarnitine and urine organic acid analyses were consistent with MADD. Genetic mutation analysis revealed a compound heterozygous mutation in EFTDH gene. The patients showed good response to riboflavin and l-carnitine treatment.
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Abstract
Metabolic and mitochondrial myopathies encompass a heterogeneous group of disorders that result in impaired energy production in skeletal muscle. Symptoms of premature muscle fatigue, sometimes leading to myalgia, rhabdomyolysis, and myoglobinuria, typically occur with exercise that would normally depend on the defective metabolic pathway. But in another group of these disorders, the dominant muscle symptom is weakness. This article reviews the clinical features, diagnosis, and management of these diseases with emphasis on the recent literature.
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Affiliation(s)
- Lydia J Sharp
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Neuromuscular Center, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, 7232 Greenville Avenue, Dallas, TX 75231, USA
| | - Ronald G Haller
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Neuromuscular Center, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, 7232 Greenville Avenue, Dallas, TX 75231, USA; North Texas VA Medical Center, 4500 South Lancaster Road, Dallas, TX 75216, USA.
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Whitaker CH, Felice KJ, Silvers D, Wu Q. Fulminant lipid storage myopathy due to multiple acyl-coenzyme a dehydrogenase deficiency. Muscle Nerve 2015; 52:289-93. [DOI: 10.1002/mus.24552] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Charles H. Whitaker
- Department of Neuromuscular Medicine; Hospital for Special Care; 2150 Corbin Avenue New Britain Connecticut 06053 USA
| | - Kevin J. Felice
- Department of Neuromuscular Medicine; Hospital for Special Care; 2150 Corbin Avenue New Britain Connecticut 06053 USA
| | - David Silvers
- Department of Neurology; Hartford Hospital; Hartford Connecticut USA
| | - Qian Wu
- Deparment of Pathology; University of Connecticut Health Center; Farmington Connecticut USA
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Shioya A, Takuma H, Yamaguchi S, Ishii A, Hiroki M, Fukuda T, Sugie H, Shigematsu Y, Tamaoka A. Amelioration of acylcarnitine profile using bezafibrate and riboflavin in a case of adult-onset glutaric acidemia type 2 with novel mutations of the electron transfer flavoprotein dehydrogenase (ETFDH) gene. J Neurol Sci 2014; 346:350-2. [DOI: 10.1016/j.jns.2014.08.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/30/2014] [Accepted: 08/26/2014] [Indexed: 12/31/2022]
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Spectrum of metabolic myopathies. Biochim Biophys Acta Mol Basis Dis 2014; 1852:615-21. [PMID: 24997454 DOI: 10.1016/j.bbadis.2014.06.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 06/19/2014] [Accepted: 06/25/2014] [Indexed: 11/24/2022]
Abstract
Metabolic myopathies are disorders of utilization of carbohydrates or fat in muscles. The acute nature of energy failure is manifested either by a metabolic crisis with weakness, sometimes associated with respiratory failure, or by myoglobinuria. A typical disorder where permanent weakness occurs is glycogenosis type II (GSDII or Pompe disease) both in infantile and late-onset forms, where respiratory insufficiency is manifested by a large number of cases. In GSDII the pathogenetic mechanism is still poorly understood, and has to be attributed more to structural muscle alterations, possibly in correlation to macro-autophagy, rather than to energetic failure. This review is focused on recent advances about GSDII and its treatment, and the most recent notions about the management and treatment of other metabolic myopathies will be briefly reviewed, including glycogenosis type V (McArdle disease), glycogenosis type III (debrancher enzyme deficiency or Cori disease), CPT-II deficiency, and ETF-dehydrogenase deficiency (also known as riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency or RR-MADD). The discovery of the genetic defect in ETF dehydrogenase confirms the etiology of this syndrome. Other metabolic myopathies with massive lipid storage and weakness are carnitine deficiency, neutral lipid storage-myopathy (NLSD-M), besides RR-MADD. Enzyme replacement therapy is presented with critical consideration and for each of the lipid storage disorders, representative cases and their response to therapy is included. This article is part of a Special Issue entitled: Neuromuscular Diseases: Pathology and Molecular Pathogenesis.
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Kaneko K, Kuroda H, Izumi R, Tateyama M, Kato M, Sugimura K, Sakata Y, Ikeda Y, Hirano KI, Aoki M. A novel mutation in PNPLA2 causes neutral lipid storage disease with myopathy and triglyceride deposit cardiomyovasculopathy: A case report and literature review. Neuromuscul Disord 2014; 24:634-41. [DOI: 10.1016/j.nmd.2014.04.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/05/2014] [Accepted: 04/09/2014] [Indexed: 12/18/2022]
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Townsend KL, Tseng YH. Brown fat fuel utilization and thermogenesis. Trends Endocrinol Metab 2014; 25:168-77. [PMID: 24389130 PMCID: PMC3972344 DOI: 10.1016/j.tem.2013.12.004] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 11/29/2013] [Accepted: 12/02/2013] [Indexed: 12/16/2022]
Abstract
Brown adipose tissue (BAT) dissipates energy as heat to maintain optimal thermogenesis and to contribute to energy expenditure in rodents and possibly humans. The energetic processes executed by BAT require a readily-available fuel supply, which includes glucose and fatty acids (FAs). FAs become available by cellular uptake, de novo lipogenesis, and multilocular lipid droplets in brown adipocytes. BAT also possesses a great capacity for glucose uptake and metabolism, and an ability to regulate insulin sensitivity. These properties make BAT an appealing target for the treatment of obesity, diabetes, and other metabolic disorders. Recent research has provided a better understanding of the processes of fuel utilization carried out by brown adipocytes, which is the focus of the current review.
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Affiliation(s)
- Kristy L Townsend
- Joslin Diabetes Center and Harvard Medical School, One Joslin Place, Boston, MA 02215, USA
| | - Yu-Hua Tseng
- Joslin Diabetes Center and Harvard Medical School, One Joslin Place, Boston, MA 02215, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA.
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Wang E, Zhao E, Hong Y, Lam JWY, Tang BZ. A highly selective AIE fluorogen for lipid droplet imaging in live cells and green algae. J Mater Chem B 2014; 2:2013-2019. [DOI: 10.1039/c3tb21675f] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
An aggregation-induced emission fluorogen, TPE-AmAl, is reported to selectively image lipid droplets in live cells and green algae with high selectivity, high specificity, excellent photostability and low cytotoxicity.
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Affiliation(s)
- Erjing Wang
- HKUST-Shenzhen Research Institute
- Shenzhen, China
- Department of Chemistry
- Division of Biomedical Engineering
- Division of Life Science, State Key laboratory of Molecular Neuroscience, Institute of Molecular Functional Materials and Institute for Advanced Study
| | - Engui Zhao
- HKUST-Shenzhen Research Institute
- Shenzhen, China
- Department of Chemistry
- Division of Biomedical Engineering
- Division of Life Science, State Key laboratory of Molecular Neuroscience, Institute of Molecular Functional Materials and Institute for Advanced Study
| | - Yuning Hong
- HKUST-Shenzhen Research Institute
- Shenzhen, China
- Department of Chemistry
- Division of Biomedical Engineering
- Division of Life Science, State Key laboratory of Molecular Neuroscience, Institute of Molecular Functional Materials and Institute for Advanced Study
| | - Jacky W. Y. Lam
- HKUST-Shenzhen Research Institute
- Shenzhen, China
- Department of Chemistry
- Division of Biomedical Engineering
- Division of Life Science, State Key laboratory of Molecular Neuroscience, Institute of Molecular Functional Materials and Institute for Advanced Study
| | - Ben Zhong Tang
- HKUST-Shenzhen Research Institute
- Shenzhen, China
- Department of Chemistry
- Division of Biomedical Engineering
- Division of Life Science, State Key laboratory of Molecular Neuroscience, Institute of Molecular Functional Materials and Institute for Advanced Study
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Liang WC, Nishino I. Riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency: A frequent condition in the southern Chinese population. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/ncn3.45] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Wen-Chen Liang
- Department of Pediatrics; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Pediatrics; School of Medicine; College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Ichizo Nishino
- Department of Neuromuscular Research; National Institute of Neuroscience; National Center of Neurology and Psychiatry; Tokyo Japan
- Department of Clinical Development; Translational Medical Center; National Center of Neurology and Psychiatry; Tokyo Japan
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41
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Angelini C, Nascimbeni AC, Semplicini C. Therapeutic advances in the management of Pompe disease and other metabolic myopathies. Ther Adv Neurol Disord 2013; 6:311-21. [PMID: 23997816 DOI: 10.1177/1756285613487570] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The world of metabolic myopathies has been dramatically modified by the advent of enzyme replacement therapy (ERT), the first causative treatment for glycogenosis type II (GSDII) or Pompe disease, which has given new impetus to research into that disease and also other pathologies. This article reviews new advances in the treatment of GSDII, the consensus about ERT, and its limitations. In addition, the most recent knowledge regarding the pathophysiology, phenotype, and genotype of the disease is discussed. Pharmacological, immunotherapy, nutritional, and physical/rehabilitative treatments for late-onset Pompe disease and other metabolic myopathies are covered, including treatments for defects in glycogen metabolism, such as glycogenosis type V (McArdle disease), and glycogenosis type III (debrancher enzyme deficiency), and defects in lipid metabolism, such as carnitine palmitoyltransferase II deficiency and electron transferring flavoprotein dehydrogenase deficiency, or riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency.
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Ramakrishnan S, Narayanappa G, Christopher R. Lipid storage myopathy with clinical markers of Marfan syndrome: A rare association. Ann Indian Acad Neurol 2013; 15:332-5. [PMID: 23349609 PMCID: PMC3548382 DOI: 10.4103/0972-2327.104352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 12/30/2011] [Accepted: 02/25/2012] [Indexed: 12/30/2022] Open
Abstract
Disorders of lipid metabolism can cause variable clinical presentations, often involving skeletal muscle, alone or together with other tissues. A 19-year-old boy presented with a 2-year history of muscle pain, cramps, exercise intolerance and progressive weakness of proximal lower limbs. Examination revealed skeletal markers of Marfan syndrome in the form of increased arm span compared with height, Kyphoscoliois, moderate pectus excavatum, high arched palate and wrist sign. He also had mild neck flexor weakness and proximal lower limb weakness with areflexia. Pathologic findings revealed lipid-laden fine vacuoles in the muscle fibers. Possibility of carnitine deficiency myopathy was considered and the patient was started on carnitine and Co Q. The patient made remarkable clinical improvement over the next 2 months. This case is reported for rarity of the association of clinical markers of Marfan syndrome and lipid storage myopathy and sparse literature on lipid storage myopathy in the Indian context.
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Affiliation(s)
- Subasree Ramakrishnan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
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Sponseller BT, Valberg SJ, Schultz NE, Bedford H, Wong DM, Kersh K, Shelton GD. Equine multiple acyl-CoA dehydrogenase deficiency (MADD) associated with seasonal pasture myopathy in the midwestern United States. J Vet Intern Med 2012; 26:1012-8. [PMID: 22708588 DOI: 10.1111/j.1939-1676.2012.00957.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 02/16/2012] [Accepted: 05/09/2012] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Seasonal pasture myopathy (SPM) is a highly fatal form of nonexertional rhabdomyolysis that occurs in pastured horses in the United States during autumn or spring. In Europe, a similar condition, atypical myopathy (AM), is common. Recently, a defect of lipid metabolism, multiple acyl-CoA dehydrogenase deficiency (MADD), has been identified in horses with AM. OBJECTIVE To determine if SPM in the United States is caused by MADD. ANIMALS Six horses diagnosed with SPM based on history, clinical signs, and serum creatine kinase activity, or postmortem findings. METHODS Retrospective descriptive study. Submissions to the Neuromuscular Diagnostic Laboratory at the University of Minnesota were reviewed between April 2009 and January 2010 to identify cases of SPM. Inclusion criteria were pastured, presenting with acute nonexertional rhabdomyolysis, and serum, urine, or muscle samples available for analysis. Horses were evaluated for MADD by urine organic acids, serum acylcarnitines, muscle carnitine, or histopathology. RESULTS Six horses had clinical signs and, where performed (4/6 horses), postmortem findings consistent with SPM. Affected muscle (4/4) showed degeneration with intramyofiber lipid accumulation, decreased free carnitine concentration, and increased carnitine esters. Serum acylcarnitine profiles (3/3) showed increases in short- and medium-chain acylcarnitines and urinary organic acid profiles (3/3) revealed increased ethylmalonic and methylsuccinic acid levels, and glycine conjugates, consistent with equine MADD. CONCLUSIONS AND CLINICAL IMPORTANCE Similar to AM, the biochemical defect causing SPM is MADD, which causes defective muscular lipid metabolism and excessive myofiber lipid content. Diagnosis can be made by assessing serum acylcarnitine and urine organic acid profiles.
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Affiliation(s)
- B T Sponseller
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA.
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Rosa M, Pascarella A, Parenti G, Buono S, Romano A, Della Casa R, Andria G, Marino M, Riccio MP, Bravaccio C. Developmental evolution in a patient with multiple acyl-coenzymeA dehydrogenase deficiency under pharmacological treatment. Eur J Paediatr Neurol 2012; 16:203-5. [PMID: 21868270 DOI: 10.1016/j.ejpn.2011.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 05/23/2011] [Accepted: 07/17/2011] [Indexed: 12/30/2022]
Abstract
PURPOSE evaluate the psychomotor evolution of a child with Multiple acyl-CoA dehydrogenase deficiency after treatment with L-carnitine, ubiquinone and riboflavin. METHODS an assessment of psychomotor development was performed before the start of farmacological treatment using the Assessment Scale of Mental Development Griffiths (GMDS-R, 0-2 years). The same assessment was performed after a month and after six months of treatment to evaluate the possible benefits of treatment. RESULTS we noticed a quick and dramatic improvement in muscular tone and motor performances after pharmacological treatment. We also observed a substantial improvement in the personal/social and hearing/language areas, suggesting the presence of intellectual/cognitive improvement. The clinical improvement correlated with the biochemical response. CONCLUSION In our patient early therapy resulted in a optimal response in psychomotor development, motor function and muscole hypotonia. Evaluation with GMDS-R, a simple, non-invasive and multidimensional tool, represents a useful instrument to monitor the clinical response to treatment.
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Affiliation(s)
- M Rosa
- Department of Pediatrics, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy
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Cotelli MS, Vielmi V, Rimoldi M, Rizzetto M, Castellotti B, Bertasi V, Todeschini A, Gregorelli V, Baronchelli C, Gellera C, Padovani A, Filosto M. Riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency with unknown genetic defect. Neurol Sci 2011; 33:1383-7. [PMID: 22190129 DOI: 10.1007/s10072-011-0900-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Accepted: 12/13/2011] [Indexed: 10/14/2022]
Abstract
Multiple acyl-CoA dehydrogenase deficiency (MADD) is a rare autosomal recessively inherited disorder of fatty acid metabolism due to ETFA, ETFB or ETFDH mutations. Riboflavin treatment ameliorates symptoms and metabolic profile in ETFDH-related MADD patients. We report on a 20-year-old boy with an 8-year history of progressive difficulty in walking, running and climbing stairs. Muscle biopsy showed a lipid myopathy and the acylcarnitine profile analysis was suggestive of MADD. Nevertheless, no evidence of molecular defects in the ETFA, ETFB and ETFDH exons or intron-exon boundaries was found. Treatment with riboflavin for 1 year resulted in a clear improvement in motor functions. Our report shows that some cases of MADD are not linked to ETFA, ETFB and ETFDH exon or intron-exon boundary changes. They could be due to quite rare promoter or deep intronic mutations or, most likely, to some unknown genetic defect. We therefore suggest to extend in these cases molecular studies to cDNA analysis and indicate the need of extensive pedigree studies to identify other possible disease-related loci. Most important, treatment of these cases with riboflavin can also be effective. Therefore, early diagnosis is essential to achieve the best treatment response.
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Affiliation(s)
- Maria Sofia Cotelli
- Clinical Neurology, Section for Neuromuscular Diseaseas and Neuropathies, University Hospital "Spedali Civili", Pz.le Spedali Civili 1, 25100, Brescia, Italy
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Abstract
UNLABELLED Barth syndrome (OMIM #302060) (BTHS) is an X-linked disorder of lipid metabolism characterized by skeletal myopathy, neutropenia, growth delay, and cardiomyopathy. It is caused by mutations in the tafazzin gene (TAZ), which lead to decreased production of an enzyme required to produce cardiolipin, a component of the inner mitochondrial membrane necessary for proper functioning of the electron transport chain. The most common initial presentation of BTHS is significant heart failure due to cardiomyopathy, which is the main cause of death in infancy or childhood. On the other hand, some patients have limited clinical features of BTHS. These patients may be overlooked or misdiagnosed with unclassified congenital myopathy, especially when heart failure is not clinically significant. However, these patients could also develop significant heart failure or life-threatening arrhythmias during or even after childhood. Heart failure in BTHS is often responsive to standard medical therapy, indicating early diagnosis is critical. Diagnostic clues of BTHS in the subclinical stage of heart failure include family histories, findings of lipid storage myopathy in the skeletal muscle biopsy, and elevated plasma brain natriuretic peptide levels. The genetic analysis of TAZ is the only confirmatory method for the diagnosis of BTHS. CONCLUSION physicians should be aware of the possibility of this disease and carry out genetic studies when it is considered.
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