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Russo V, Antonini G, Massa R, Casali C, Mauriello A, Martino AM, Marconi R, Garibaldi M, Franciosa P, Zecchin M, Gaudio C, D'Andrea A, Strano S. Comprehensive Cardiovascular Management of Myotonic Dystrophy Type 1 Patients: A Report from the Italian Neuro-Cardiology Network. J Cardiovasc Dev Dis 2024; 11:63. [PMID: 38392277 PMCID: PMC10889677 DOI: 10.3390/jcdd11020063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
Myotonic dystrophy is a hereditary disorder with systemic involvement. The Italian Neuro-Cardiology Network-"Rete delle Neurocardiologie" (INCN-RNC) is a unique collaborative experience involving neurology units combined with cardio-arrhythmology units. The INCN facilitates the creation of integrated neuro-cardiac teams in Neuromuscular Disease Centers for the management of cardiovascular involvement in the treatment of myotonic dystrophy type 1 (MD1).
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Affiliation(s)
- Vincenzo Russo
- Cardiology Unit, Department of Medical Translational Sciences, University of Campania "Luigi Vanvitelli"-"Monaldi" Hospital, 80126 Naples, Italy
| | - Giovanni Antonini
- Neuromuscular Disease Centre, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, "Sant'Andrea" Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
| | - Roberto Massa
- Neuromuscular Diseases Unit, Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Carlo Casali
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00196 Rome, Italy
| | - Alfredo Mauriello
- Cardiology Unit, Department of Medical Translational Sciences, University of Campania "Luigi Vanvitelli"-"Monaldi" Hospital, 80126 Naples, Italy
- Department of Cardiology, "Umberto I" Hospital, 84014 Nocera Inferiore, Italy
| | | | - Roberto Marconi
- Unit of Neurology, Cardio-Thoracic-Neuro-Vascular Department, "Misericordia" Hospital, 58100 Grosseto, Italy
| | - Matteo Garibaldi
- Neuromuscular Disease Centre, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, "Sant'Andrea" Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
| | - Pasquale Franciosa
- Department of Internal, Anesthesiological and Cardiovascular Clinical Sciences, Sapienza University of Rome, 00196 Rome, Italy
| | - Massimo Zecchin
- Cardiothoracovascular Department, "Cattinara" Hospital, ASUGI and University of Trieste, 34149 Trieste, Italy
| | - Carlo Gaudio
- Department of Internal, Anesthesiological and Cardiovascular Clinical Sciences, Sapienza University of Rome, 00196 Rome, Italy
| | - Antonello D'Andrea
- Department of Cardiology, "Umberto I" Hospital, 84014 Nocera Inferiore, Italy
| | - Stefano Strano
- Department of Internal, Anesthesiological and Cardiovascular Clinical Sciences, Sapienza University of Rome, 00196 Rome, Italy
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Liu B, Yang CL, Li XL, Zhang M, Li YB, Duan RS. CADASIL-like leukodystrophy and symptomatic cerebral infarction in myotonic dystrophy type 1. CNS Neurosci Ther 2022; 28:1655-1657. [PMID: 35785420 PMCID: PMC9437229 DOI: 10.1111/cns.13908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Bin Liu
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.,Shandong Institute of Neuroimmunology, Jinan, China
| | - Chun-Lin Yang
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.,Shandong Institute of Neuroimmunology, Jinan, China
| | - Xiao-Li Li
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.,Shandong Institute of Neuroimmunology, Jinan, China
| | - Min Zhang
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.,Shandong Institute of Neuroimmunology, Jinan, China
| | - Yan-Bin Li
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.,Shandong Institute of Neuroimmunology, Jinan, China
| | - Rui-Sheng Duan
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.,Shandong Institute of Neuroimmunology, Jinan, China
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3
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Lee CH, Jeon SH, Shin BS, Kang HG. Basilar Artery Dissection in Myotonic Dystrophy Type 1. J Clin Neurol 2022; 18:227-229. [PMID: 35274839 PMCID: PMC8926772 DOI: 10.3988/jcn.2022.18.2.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Chan-Hyuk Lee
- Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Seung-Ho Jeon
- Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Byoung-Soo Shin
- Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Hyun Goo Kang
- Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
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Lee JY, Jeong HN. Nationwide incidence of myotonic dystrophy type 1 and the status of multi-organ involvement. J Neurol 2021; 269:2666-2672. [PMID: 34704149 DOI: 10.1007/s00415-021-10875-1] [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] [Received: 08/20/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to investigate the incidence of myotonic dystrophy type 1 (DM1) and the status of multi-organ involvement. METHODS This was a nationwide, population-based, cohort study using data from the Korean National Health Claims database. All patients with DM1 from the entire population aged ≤ 80 years were included. To identify possible systemic diseases along with DM1, we searched for concurrent codes for systemic diseases. To assess the recent status of systemic evaluation, concurrent codes for various diagnostic and treatment modalities were collected. Cumulative incidence during 2016-2019 was first evaluated then systemic evaluation for those patients was assessed during 2010-2019. RESULTS A total of 387 patients (47.8% men) during the recent 4-year study period (2016-2019) were diagnosed with DM1. The cumulative incidence in the general population was 0.77 (95% confidence interval: 0.76-0.77) per 100,000 persons. In newly developed incidental cases, cardiac involvement developed in 51.2%, pneumonia in 30.7%, diabetes in 26.9%, brain involvement in 18.1%, cataract in 13.7%, and cancers in 5.4% of total patients. Electrocardiography was performed in 93.8%, Holter in 33.9%, and echocardiography in 31.3% of the total patients for cardiac evaluation. CONCLUSIONS The incidence estimates of DM1 in the Asian population were lower than those of Caucasians. This study provides the real situation of screening and treatment for systemic diseases related to DM1. These detailed estimates could promote an understanding of the current disease status and allow for appropriate planning within the healthcare system.
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Affiliation(s)
- Ju-Yeun Lee
- Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.,Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Ha-Neul Jeong
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, 55, Hwasu-ro 14, Deogyang-gu, Goyang-si, Gyeonggi-do, 10475, Republic of Korea. .,Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Russo V, Papa AA, Lioncino M, Rago A, Di Fraia F, Palladino A, Politano L, Golino P, Nigro G. Prevalence of atrial fibrillation in myotonic dystrophy type 1: A systematic review. Neuromuscul Disord 2021; 31:281-290. [PMID: 33573883 DOI: 10.1016/j.nmd.2021.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/22/2020] [Accepted: 01/02/2021] [Indexed: 12/26/2022]
Abstract
Cardiac involvement is recorded in about 80% of patients affected by myotonic dystrophy type 1 (DM1). The prevalence of cardiac conduction abnormalities is well described. Data regarding the prevalence of atrial fibrillation (AF) are still conflicting. The primary objective of this review was to assess the prevalence of AF in DM1. The secondary aim was to examine the association of clinical features with AF, to detect predisposing and/or influencing prognosis factors. A systematic search was developed in MEDLINE, EMBASE, Cochrane Register of Controlled Trials and Web of Science databases, to identify original reports between January 1, 2002 and January 30, 2020, assessing the prevalence of AF in DM1 population. Retrospective/prospective cohort studies and case series describing the prevalence of atrial fibrillation evaluated by periodic electrocardiogram (ECG) and/or ECG Holter 24 h, external loop recording (ELR) and implantable devices interrogation in DM1 patients were included. Case reports, simple reviews, commentaries and editorials were excluded. Thirteen reports fulfilled eligibility criteria and were included in our systematic review. According to the results from all the evaluated studies, the mean prevalence of AF in DM1 patients was 10.9% (n = 404) in 3677 DM1 patients. Male sex, conduction defects, echocardiographic findings of prolonged atrial electromechanical delay seem to be strongly associated with atrial fibrillation, representing factors favoring its onset. DM1 patients who develop AF seem to have a higher risk of cardiovascular and non-cardiovascular death. Further studies are needed to assess the prevalence of AF in DM1 patients and to investigate ECG abnormalities and other clinical features associated with this condition.
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Affiliation(s)
- Vincenzo Russo
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Naples, Italy
| | - Andrea Antonio Papa
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Naples, Italy.
| | - Michele Lioncino
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Naples, Italy
| | - Anna Rago
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Naples, Italy
| | - Francesco Di Fraia
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Naples, Italy
| | - Alberto Palladino
- Cardiomyology and Medical Genetics, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luisa Politano
- Cardiomyology and Medical Genetics, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paolo Golino
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Naples, Italy
| | - Gerardo Nigro
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Naples, Italy
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Meziab O, Marcondes L, Friedman KG, O'Leary ET, Gurvitz M, VanderPluym CJ, Walsh EP, Triedman JK, Mah DY. Difference in the prevalence of intracardiac thrombus on the first presentation of atrial fibrillation versus flutter in the pediatric and congenital heart disease population. J Cardiovasc Electrophysiol 2020; 31:3243-3250. [PMID: 33112018 DOI: 10.1111/jce.14791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/05/2020] [Accepted: 10/21/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Guidelines recommend trans-esophageal echocardiography (TEE) for patients with atrial fibrillation (AF) or atrial flutter (AFL) for >48 h, due to risk of intracardiac thrombus formation. With growing evidence that AFL in adults with structurally normal hearts has less thrombogenic potential compared to AF, and the need for TEE questioned, we compared prevalence of intracardiac thrombus detected by TEE in pediatric and congenital heart disease (CHD) patients presenting in AF and AFL. METHODS/RESULTS Single-center, cross-sectional analysis for unique first-time presentations of patients for either AF, AFL, or intra-atrial reentrant tachycardia (IART) between 2000 and 2019. Patients were categorized by presenting arrhythmia (AF vs. AFL/IART), with the exclusion of other forms of atrial tachycardia, hemodynamic instability, chronic anti-coagulation before TEE, and presentation for a reason other than TEE examination for thrombus. A total of 201 patients had TEE with co-diagnosis of AF or AFL. Of these, 105 patients (29 AF, 76 AFL) met inclusion criteria, with no difference in age between AF (median 24.9 years; IQR 18.6-38.3 years) and AFL/IART (23.3 years; 15.4-38.4 years). The prevalence of thrombus in the entire cohort was 9.5%, with no difference between AF (13.8%) and AFL groups (7.9%), p = .46. Patients with thrombus demonstrated no difference in age, systemic ventricular function, cardiac complexity, or CHADS2/CHA2DS2VASc score at presentation. CONCLUSIONS The risk for intracardiac thrombus is high in the pediatric and CHD population, with no apparent distinguishing factors to warrant a change in the recommendations for TEE, with all levels of cardiac complexity being at risk for clot.
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Affiliation(s)
- Omar Meziab
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Luciana Marcondes
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kevin G Friedman
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Edward T O'Leary
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michelle Gurvitz
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Christina J VanderPluym
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Edward P Walsh
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - John K Triedman
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Douglas Y Mah
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Gutiérrez Gutiérrez G, Díaz-Manera J, Almendrote M, Azriel S, Eulalio Bárcena J, Cabezudo García P, Camacho Salas A, Casanova Rodríguez C, Cobo A, Díaz Guardiola P, Fernández-Torrón R, Gallano Petit M, García Pavía P, Gómez Gallego M, Gutiérrez Martínez A, Jericó I, Kapetanovic García S, López de Munaín Arregui A, Martorell L, Morís de la Tassa G, Moreno Zabaleta R, Muñoz-Blanco J, Olivar Roldán J, Pascual Pascual S, Peinado Peinado R, Pérez H, Poza Aldea J, Rabasa M, Ramos A, Rosado Bartolomé A, Rubio Pérez M, Urtizberea J, Zapata-Wainberg G, Gutiérrez-Rivas E. Guía clínica para el diagnóstico y seguimiento de la distrofia miotónica tipo 1, DM1 o enfermedad de Steinert. Neurologia 2020; 35:185-206. [DOI: 10.1016/j.nrl.2019.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/05/2019] [Indexed: 01/18/2023] Open
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Gutiérrez Gutiérrez G, Díaz-Manera J, Almendrote M, Azriel S, Eulalio Bárcena J, Cabezudo García P, Camacho Salas A, Casanova Rodríguez C, Cobo A, Díaz Guardiola P, Fernández-Torrón R, Gallano Petit M, García Pavía P, Gómez Gallego M, Gutiérrez Martínez A, Jericó I, Kapetanovic García S, López de Munaín Arregui A, Martorell L, Morís de la Tassa G, Moreno Zabaleta R, Muñoz-Blanco J, Olivar Roldán J, Pascual Pascual S, Peinado Peinado R, Pérez H, Poza Aldea J, Rabasa M, Ramos A, Rosado Bartolomé A, Rubio Pérez M, Urtizberea J, Zapata-Wainberg G, Gutiérrez-Rivas E. Clinical guide for the diagnosis and follow-up of myotonic dystrophy type 1, MD1 or Steinert's disease. NEUROLOGÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.nrleng.2019.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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McNally EM, Mann DL, Pinto Y, Bhakta D, Tomaselli G, Nazarian S, Groh WJ, Tamura T, Duboc D, Itoh H, Hellerstein L, Mammen PPA. Clinical Care Recommendations for Cardiologists Treating Adults With Myotonic Dystrophy. J Am Heart Assoc 2020; 9:e014006. [PMID: 32067592 PMCID: PMC7070199 DOI: 10.1161/jaha.119.014006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Myotonic dystrophy is an inherited systemic disorder affecting skeletal muscle and the heart. Genetic testing for myotonic dystrophy is diagnostic and identifies those at risk for cardiac complications. The 2 major genetic forms of myotonic dystrophy, type 1 and type 2, differ in genetic etiology yet share clinical features. The cardiac management of myotonic dystrophy should include surveillance for arrhythmias and left ventricular dysfunction, both of which occur in progressive manner and contribute to morbidity and mortality. To promote the development of care guidelines for myotonic dystrophy, the Myotonic Foundation solicited the input of care experts and organized the drafting of these recommendations. As a rare disorder, large scale clinical trial data to guide the management of myotonic dystrophy are largely lacking. The following recommendations represent expert consensus opinion from those with experience in the management of myotonic dystrophy, in part supported by literature-based evidence where available.
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Affiliation(s)
| | | | - Yigal Pinto
- University of AmsterdamAmsterdamThe Netherlands
| | | | | | | | | | - Takuhisa Tamura
- National Hospital Organization Higashisaitama National HospitalSaitamaJapan
| | - Denis Duboc
- Hopital CochinUniversite Paris DescartesParisFrance
| | - Hideki Itoh
- Shiga University of Medical ScienceShigaJapan
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Guía clínica para el diagnóstico y seguimiento de la distrofia miotónica tipo 1, DM1 o enfermedad de Steinert. Med Clin (Barc) 2019; 153:82.e1-82.e17. [DOI: 10.1016/j.medcli.2018.10.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/15/2018] [Accepted: 10/18/2018] [Indexed: 01/19/2023]
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Wenninger S, Montagnese F, Schoser B. Core Clinical Phenotypes in Myotonic Dystrophies. Front Neurol 2018; 9:303. [PMID: 29770119 PMCID: PMC5941986 DOI: 10.3389/fneur.2018.00303] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/18/2018] [Indexed: 12/22/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) and type 2 (DM2) represent the most frequent multisystemic muscular dystrophies in adulthood. They are progressive, autosomal dominant diseases caused by an abnormal expansion of an unstable nucleotide repeat located in the non-coding region of their respective genes DMPK for DM1 and CNBP in DM2. Clinically, these multisystemic disorders are characterized by a high variability of muscular and extramuscular symptoms, often causing a delay in diagnosis. For both subtypes, many symptoms overlap, but some differences allow their clinical distinction. This article highlights the clinical core features of myotonic dystrophies, thus facilitating their early recognition and diagnosis. Particular attention will be given to signs and symptoms of muscular involvement, to issues related to respiratory impairment, and to the multiorgan involvement. This article is part of a Special Issue entitled “Beyond Borders: Myotonic Dystrophies—A European Perception.”
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Affiliation(s)
- Stephan Wenninger
- Friedrich-Baur-Institute, Klinikum der Universität München, Munich, Germany
| | | | - Benedikt Schoser
- Friedrich-Baur-Institute, Klinikum der Universität München, Munich, Germany
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