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Cheung A, Audhya IF, Szabo SM, Friesen M, Weihl CC, Gooch KL. Patterns of Clinical Progression Among Patients With Autosomal Recessive Limb-Girdle Muscular Dystrophy: A Systematic Review. J Clin Neuromuscul Dis 2023; 25:65-80. [PMID: 37962193 DOI: 10.1097/cnd.0000000000000461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
OBJECTIVES As the clinical course of autosomal recessive limb-girdle muscular dystrophy (LGMDR) is highly variable, this study characterized the frequency of loss of ambulation (LOA) among patients by subtype (LGMDR1, LGMDR2, LGMDR3-6, LGMDR9, LGMDR12) and progression to cardiac and respiratory involvement among those with and without LOA. METHODS Systematic literature review. RESULTS From 2929 abstracts screened, 418 patients were identified with ambulatory status data (LOA: 265 [63.4%]). Cardiac and/or respiratory function was reported for 142 patients (34.0%; all with LOA). Among these, respiratory involvement was most frequent in LGMDR3-6 (74.1%; mean [SD] age 23.9 [11.0] years) and cardiac in LGMDR9 (73.3%; mean [SD] age 23.7 [17.7] years). Involvement was less common in patients without LOA except in LGMDR9 (71.4% respiratory and 52.4% cardiac). CONCLUSIONS This study described the co-occurrence of LOA, cardiac, and respiratory involvement in LGMDR and provides greater understanding of the clinical progression of LGMDR.
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Affiliation(s)
| | | | | | | | - Conrad C Weihl
- Department of Neurology, Hope Center for Neurological Diseases, Washington University School of Medicine, St. Louis, MO
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2
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Yedigaryan L, Sampaolesi M. Therapeutic Implications of miRNAs for Muscle-Wasting Conditions. Cells 2021; 10:cells10113035. [PMID: 34831256 PMCID: PMC8616481 DOI: 10.3390/cells10113035] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 12/14/2022] Open
Abstract
MicroRNAs (miRNAs) are small, non-coding RNA molecules that are mainly involved in translational repression by binding to specific messenger RNAs. Recently, miRNAs have emerged as biomarkers, relevant for a multitude of pathophysiological conditions, and cells can selectively sort miRNAs into extracellular vesicles for paracrine and endocrine effects. In the overall context of muscle-wasting conditions, a multitude of miRNAs has been implied as being responsible for the typical dysregulation of anabolic and catabolic pathways. In general, chronic muscle disorders are associated with the main characteristic of a substantial loss in muscle mass. Muscular dystrophies (MDs) are a group of genetic diseases that cause muscle weakness and degeneration. Typically, MDs are caused by mutations in those genes responsible for upholding the integrity of muscle structure and function. Recently, the dysregulation of miRNA levels in such pathological conditions has been reported. This revelation is imperative for both MDs and other muscle-wasting conditions, such as sarcopenia and cancer cachexia. The expression levels of miRNAs have immense potential for use as potential diagnostic, prognostic and therapeutic biomarkers. Understanding the role of miRNAs in muscle-wasting conditions may lead to the development of novel strategies for the improvement of patient management.
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Affiliation(s)
- Laura Yedigaryan
- Translational Cardiomyology Laboratory, Stem Cell Biology and Embryology, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium;
| | - Maurilio Sampaolesi
- Translational Cardiomyology Laboratory, Stem Cell Biology and Embryology, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium;
- Histology and Medical Embryology Unit, Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
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3
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Quick S, Winkler M, Speiser U, Ibrahim K, Schäfer J, Linke A, Zhang K, Christoph M, Heidrich FM. Myocardial strain analysis using cardiac magnetic resonance in patients with calpainopathy. Orphanet J Rare Dis 2021; 16:194. [PMID: 33931068 PMCID: PMC8086059 DOI: 10.1186/s13023-021-01826-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Limb-girdle muscular dystrophy (LGMD) is a genetically and clinically heterogeneous group of rare muscular dystrophies. Subtype 2A (LGMD2A) also known as "calpainopathy" is an inherited autosomal recessive gene defect. Cardiac dysfunction is common in several forms of LGMD. Cardiac involvement in LGMD2A, however, is not clear. The aim of this study was to perform cardiac magnetic resonance (CMR)-based strain analysis in LGMD2A patients, as this is a diagnostic parameter of subclinical cardiac involvement and a powerful independent predictor of mortality. We conducted the largest prospective cardiac magnetic resonance study to date, including 11 genetically verified LGMD2A patients and 11 age- and sex-matched control subjects and performed CMR-based strain analysis of the left and right ventricles. RESULTS Left and right global longitudinal strain (GLS) were not significantly different between the two groups and within normal reference ranges (left ventricle: control - 21.8 (5.1) % vs. patients - 22.3 (3.2) %, p = 0.38; right ventricle: control - 26.3 (7.2) % vs. patients - 26.8 (5.8) %, p = 0.85). Also, global circumferential and radial strains did not significantly differ between the two groups (p = 0.95 and p = 0.86, respectively). LGMD2A patients did not show relevant amounts of late gadolinium enhancement (LGE) or malignant ventricular arrhythmias. CONCLUSIONS No evidence of even subtle cardiac dysfunction is evident form CMR-based strain analysis in LGMD2A patients. Malignant ventricular arrhythmias were not detected. Thus, in case of non-pathological initial echocardiographic and electrocardiographic examination, a less frequent or even no cardiac follow-up may be acceptable in these patients. However, if there are signs and symptoms that suggest an underlying cardiac condition (e.g. palpitations, angina, shortness of breath), this approach needs to be individualized to account for the unknown.
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Affiliation(s)
- Silvio Quick
- Department of Cardiology, Angiology and Intensive Care, Klinikum Chemnitz gGmbH, Medizincampus Chemnitz der Technischen Universität Dresden, Chemnitz, Germany
| | - Max Winkler
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden Universitätsklinik, Technische Universität Dresden, Dresden, Germany
| | - Uwe Speiser
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden Universitätsklinik, Technische Universität Dresden, Dresden, Germany
| | - Karim Ibrahim
- Department of Cardiology, Angiology and Intensive Care, Klinikum Chemnitz gGmbH, Medizincampus Chemnitz der Technischen Universität Dresden, Chemnitz, Germany
| | - Jochen Schäfer
- Department of Neurology, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Axel Linke
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden Universitätsklinik, Technische Universität Dresden, Dresden, Germany
| | - Kun Zhang
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Marian Christoph
- Department of Cardiology, Angiology and Intensive Care, Klinikum Chemnitz gGmbH, Medizincampus Chemnitz der Technischen Universität Dresden, Chemnitz, Germany
| | - Felix M Heidrich
- Department of Internal Medicine and Cardiology, Herzzentrum Dresden Universitätsklinik, Technische Universität Dresden, Dresden, Germany.
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4
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Martens K, Leckie J, Fok D, Wells RA, Chhibber S, Pfeffer G. Case Report: Calpainopathy Presenting After Bone Marrow Transplantation, With Studies of Donor Genetic Content in Various Tissue Types. Front Neurol 2021; 11:604547. [PMID: 33505349 PMCID: PMC7829329 DOI: 10.3389/fneur.2020.604547] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/02/2020] [Indexed: 11/23/2022] Open
Abstract
We present a patient who had two allogeneic bone marrow transplantations for acute lymphocytic leukemia. She developed slowly progressive limb-girdle weakness in the context of other symptoms of graft-vs.-host disease (GVHD). Her myopathy symptoms had been initially attributed to GVHD, but when she progressed despite immunotherapy, genetic testing was requested. Initial testing was performed on a blood sample, identifying a variant of unknown significance in DMD. Subsequent testing of DNA from the patient's muscle tissue identified two pathogenic variants in CAPN3, with absence of the DMD variant (this latter variant presumed to have been received from the donor). Allele-specific digital droplet qPCR permitted the quantification of the donor variant in various tissues from the patient (whole skin, isolated fibroblasts, whole blood, saliva, buccal cells, urine sediment, and two muscle biopsies taken at a 2 year interval). This report emphasizes that genetic disease should still be considered in the context of presumably acquired disease, and also demonstrates the extent of transdifferentiation of donor cells into other tissues.
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Affiliation(s)
- Kristina Martens
- Department of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jamie Leckie
- Department of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Daniel Fok
- Division of Neurology, Department of Medicine, Kelowna General Hospital, Kelowna, BC, Canada
| | - Robyn A Wells
- Department of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Sameer Chhibber
- Department of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Gerald Pfeffer
- Department of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Department of Medical Genetics, Alberta Child Health Research Institute, University of Calgary, Calgary, AB, Canada
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5
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Zheng J, Xu X, Zhang X, Wang X, Shu J, Cai C. Variants of CAPN3 cause limb-girdle muscular dystrophy type 2A in two Chinese families. Exp Ther Med 2020; 21:104. [PMID: 33335567 PMCID: PMC7739812 DOI: 10.3892/etm.2020.9536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/26/2020] [Indexed: 11/11/2022] Open
Abstract
Limb-girdle muscular dystrophies (LGMDs) are a group of neuromuscular diseases that are characterized by progressive muscle weakness. LGMD type 2A (LGMD2A), caused by variants in the calpain-3 (CAPN3) gene, is the most prevalent type. The present study aimed to analyze pathogenic CAPN3 gene variants in two pedigrees affected by LGMD2A. Each family contains three patients who are siblings and sought genetic counseling. Genomic DNA was extracted from the peripheral blood samples collected from the probands and family members and whole-exome sequencing (WES) was used to detect the pathogenic genes in the probands. Suspected variants were subsequently validated by Sanger sequencing. In family 1, WES revealed that the proband carried the compound heterogeneous variants c.1194-9A>G and c.1437C>T (p.Ser479=) in CAPN3 (NM_000070.2). In family 2, WES identified that the proband carried the compound heterogeneous variants c.632+4A>G and c.1468C>T (p.Arg490Trp) in CAPN3 (NM_000070.2). In conclusion, the present study indicated that the compound heterogeneous variants of the CAPN3 gene were most likely responsible for LGMD2A in the two Chinese families.
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Affiliation(s)
- Jie Zheng
- Graduate College, Tianjin Medical University, Tianjin 300070, P.R. China
| | - Xiaowei Xu
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China
| | - Xinjie Zhang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China
| | - Xuetao Wang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China
| | - Jianbo Shu
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China
| | - Chunquan Cai
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China.,Department of Neurosurgery, Tianjin Children's Hospital, Tianjin 300134, P.R. China
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6
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PERIC STOJAN, STEVANOVIC JELENA, JOHNSON KATHERINE, KOSAC ANA, PERIC MARINA, BRANKOVIC MARIJA, MARJANOVIC ANA, JANKOVIC MILENA, BANKO BOJAN, MILENKOVIC SANJA, DURDIC MILICA, BOZOVIC IVO, GLUMAC JELENANIKODINOVIC, LAVRNIC DRAGANA, MAKSIMOVIC RUZICA, MILIC-RASIC VEDRANA, RAKOCEVIC-STOJANOVIC VIDOSAVA. Phenotypic and genetic spectrum of patients with limb-girdle muscular dystrophy type 2A from Serbia. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2019; 38:163-171. [PMID: 31788660 PMCID: PMC6859413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Limb-girdle muscular dystrophy (LGMD) type 2A (calpainopathy) is an autosomal recessive disease caused by mutation in the CAPN3 gene. The aim of this study was to examine genetic and phenotypic features of Serbian patients with calpainopathy. The study comprised 19 patients with genetically confirmed calpainopathy diagnosed at the Neurology Clinic, Clinical Center of Serbia and the Clinic for Neurology and Psychiatry for Children and Youth in Belgrade, Serbia during a ten-year period. Eighteen patients in this cohort had c.550delA mutation, with nine of them being homozygous. In majority of the patients, disease started in childhood or early adulthood. The disease affected shoulder girdle - upper arm and pelvic girdle - thigh muscles with similar frequency, with muscles of lower extremities being more severely impaired. Facial and bulbar muscles were spared. All patients in this cohort, except two, remained ambulant. None of the patients had cardiomyopathy, while 21% showed mild conduction defects. Respiratory function was mildly impaired in 21% of patients. Standard muscle histopathology showed myopathic and dystrophic pattern. In conclusion, the majority of Serbian LGMD2A patients have the same mutation and similar phenotype.
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Affiliation(s)
- STOJAN PERIC
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
| | - JELENA STEVANOVIC
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
| | - KATHERINE JOHNSON
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - ANA KOSAC
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - MARINA PERIC
- Mother and Child Health Care Institute, Belgrade, Serbia
| | - MARIJA BRANKOVIC
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
| | - ANA MARJANOVIC
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
| | - MILENA JANKOVIC
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
| | - BOJAN BANKO
- Center for Magnetic Resonance Imaging, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
| | | | - MILICA DURDIC
- Center for Magnetic Resonance Imaging, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
| | - IVO BOZOVIC
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
| | | | - DRAGANA LAVRNIC
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - RUZICA MAKSIMOVIC
- Center for Magnetic Resonance Imaging, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia
| | - VEDRANA MILIC-RASIC
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - VIDOSAVA RAKOCEVIC-STOJANOVIC
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia,Address for correspondence: Vidosava Rakocevic-Stojanovic, Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade 6, Dr. Subotic Street, 11 000 Belgrade, Serbia. Tel. +381 64 2228779. Fax +381 11 2684577. E-mail:
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7
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Miskew Nichols B, Nikhanj A, Wang F, Freed DH, Oudit GY. Advanced Dilated Cardiomyopathy in a Patient With Hutterite Limb-Girdle Muscular Dystrophy: Use of a Left Ventricular Assist Device. Circ Heart Fail 2019; 11:e004960. [PMID: 29626101 DOI: 10.1161/circheartfailure.118.004960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Bailey Miskew Nichols
- Division of Cardiology, Department of Medicine (B.M.N., A.N., F.W., G.Y.O.), Division of Cardiac Surgery, Department of Surgery (D.H.F.), and Mazankowski Alberta Heart Institute (B.M.N., A.N., F.W., D.H.F., G.Y.O.), University of Alberta, Edmonton, Canada
| | - Anish Nikhanj
- Division of Cardiology, Department of Medicine (B.M.N., A.N., F.W., G.Y.O.), Division of Cardiac Surgery, Department of Surgery (D.H.F.), and Mazankowski Alberta Heart Institute (B.M.N., A.N., F.W., D.H.F., G.Y.O.), University of Alberta, Edmonton, Canada
| | - Faqi Wang
- Division of Cardiology, Department of Medicine (B.M.N., A.N., F.W., G.Y.O.), Division of Cardiac Surgery, Department of Surgery (D.H.F.), and Mazankowski Alberta Heart Institute (B.M.N., A.N., F.W., D.H.F., G.Y.O.), University of Alberta, Edmonton, Canada
| | - Darren H Freed
- Division of Cardiology, Department of Medicine (B.M.N., A.N., F.W., G.Y.O.), Division of Cardiac Surgery, Department of Surgery (D.H.F.), and Mazankowski Alberta Heart Institute (B.M.N., A.N., F.W., D.H.F., G.Y.O.), University of Alberta, Edmonton, Canada
| | - Gavin Y Oudit
- Division of Cardiology, Department of Medicine (B.M.N., A.N., F.W., G.Y.O.), Division of Cardiac Surgery, Department of Surgery (D.H.F.), and Mazankowski Alberta Heart Institute (B.M.N., A.N., F.W., D.H.F., G.Y.O.), University of Alberta, Edmonton, Canada.
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8
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Strafella C, Campoli G, Galota RM, Caputo V, Pagliaroli G, Carboni S, Zampatti S, Peconi C, Mela J, Sancricca C, Primiano G, Minozzi G, Servidei S, Cascella R, Giardina E. Limb-Girdle Muscular Dystrophies (LGMDs): The Clinical Application of NGS Analysis, a Family Case Report. Front Neurol 2019; 10:619. [PMID: 31263448 PMCID: PMC6585112 DOI: 10.3389/fneur.2019.00619] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/28/2019] [Indexed: 12/12/2022] Open
Abstract
The diagnosis of LGMD2A (calpainopathy) can be challenging due to genetic heterogeneity and to high similarity with other LGMDs or neuromuscular disorders. In this setting, NGS panels are highly recommended to perform differential diagnosis, identify new causative mutations and enable genotype-phenotype correlations. In this manuscript, the case of a patient affected by LGMD2A is reported, for which the application of a defined custom designed NGS panel allowed to confirm the diagnosis of calpainopathy linked with two heterozygous variants in CAPN3, namely c.550delA and c.1813G>C. The first variant has been extensively described in relation to calpainopathy. The second variant c.1813G>C, instead, is novel and has been predicted to be probably damaging. In addition, NGS analysis on the proband revealed a heterozygous variant (c.550C>T) in the LMNA gene, which is associated with dilated cardiomyopathy. The variant is novel and has been predicted to be deleterious by subsequent bioinformatic analysis. Successively, segregation analysis was performed on family members. Interestingly, none of them showed neuromuscular symptoms but the mother was diagnosed with bradycardia and syncopal episodes and showed a positive family history for cardiomyopathy. The segregation analysis reported that the proband inherited the c.1813G>C (CAPN3) from the father who was a healthy carrier. The mother was positive for c.550delA (CAPN3) and c.550C>T (LMNA), suggesting thereby a possible genetic explanation for her cardiovascular problems. Segregation analysis, therefore, confirmed the inheritance pattern of the variants carried by the proband and highlighted a familiarity for cardiomyopathy which should not be neglected. The NGS analysis was further performed on the partner of the proband, to estimate the reproductive risk of the couple. The partner was negative to NGS screening, suggesting thereby a low risk to have an affected child with calpainopathy and 50% probability to inherit the LMNA variant. This case report showed the clinical utility of the NGS panel in providing accurate LGMD2A diagnosis and identifying complex phenotypes originating from mutations in multiple genes. However, NGS results should always be accomplished by a dedicated genetic counseling, not only to evaluate the recurrence and reproductive risks but also to uncover unexpected findings which can be clinically significant.
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Affiliation(s)
- Claudia Strafella
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy.,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Giulia Campoli
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Rosaria Maria Galota
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Valerio Caputo
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy.,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Giulia Pagliaroli
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Stefania Carboni
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Stefania Zampatti
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Cristina Peconi
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Julia Mela
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Cristina Sancricca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurofisiopatologia, Rome, Italy.,Unione Italiana Lotta Distrofia Muscolare (UILDM), Sezione Laziale, Rome, Italy
| | - Guido Primiano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurofisiopatologia, Rome, Italy
| | - Giulietta Minozzi
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Serenella Servidei
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurofisiopatologia, Rome, Italy
| | - Raffaella Cascella
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy.,Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, Tirana, Albania
| | - Emiliano Giardina
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy.,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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9
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Mori-Yoshimura M, Segawa K, Minami N, Oya Y, Komaki H, Nonaka I, Nishino I, Murata M. Cardiopulmonary dysfunction in patients with limb-girdle muscular dystrophy 2A. Muscle Nerve 2016; 55:465-469. [PMID: 27500519 PMCID: PMC5396288 DOI: 10.1002/mus.25369] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 06/19/2016] [Accepted: 08/04/2016] [Indexed: 11/30/2022]
Abstract
Introduction: Little is known about the frequency of cardiopulmonary failure in limb‐girdle muscular dystrophy type 2A (calpainopathy) patients, although some studies have reported severe cardiomyopathy or respiratory failure. Methods: To clarify the frequency of cardiopulmonary dysfunction in this patient population, we retrospectively reviewed the respiratory and cardiac function of 43 patients with calpainopathy. Results: Nine of the 43 patients had forced vital capacity (FVC) < 80%, and 3 used noninvasive positive pressure ventilation. Mean FVC was significantly lower in patients who were nonambulant and had normal creatine kinase levels. Only 1 patient had a prolonged QRS complex duration. Echocardiography revealed that 1 patient had very mild left ventricular dysfunction. Conclusions: These findings suggest that patients with calpainopathy may develop severe respiratory failure, but cardiac dysfunction is infrequent. Muscle Nerve55: 465–469, 2017
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Affiliation(s)
- Madoka Mori-Yoshimura
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8551, Japan
| | - Kazuhiko Segawa
- Department of Cardiology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Narihiro Minami
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.,Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.,Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yasushi Oya
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8551, Japan
| | - Hirohumi Komaki
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Ikuya Nonaka
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Ichizo Nishino
- Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.,Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Miho Murata
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8551, Japan
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10
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Albuquerque MAVD, Abath Neto O, Silva FMAD, Zanoteli E, Reed UC. Limb-girdle muscular dystrophy type 2A in Brazilian children. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 73:993-7. [PMID: 26677118 DOI: 10.1590/0004-282x20150168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 08/14/2015] [Indexed: 11/22/2022]
Abstract
UNLABELLED Calpainopathy is an autosomal recessive limb girdle muscular dystrophy (LGMD2A) caused by mutations in CAPN3 gene. OBJECTIVE To present clinical and histological findings in six children with a molecular diagnosis of LGMD2A and additionally the MRI findings in two of them. METHOD We retrospectively assessed medical records of 6 patients with mutation on CAPN3 gene. RESULTS All patients were female (three to 12 years). The mean of age of disease onset was 9 years. All of them showed progressive weakness with predominance in lower limbs. Other findings were scapular winging, joint contractures and calf hypertrophy. One female had a more severe phenotype than her dizygotic twin sister that was confirmed by muscle MRI. Muscle biopsies showed a dystrophic pattern in all patients. CONCLUSION In this cohort of children with LGMD2A, the clinical aspects were similar to adults with the same disorder.
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Affiliation(s)
| | - Osório Abath Neto
- Departamento de Neurologia, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | | | - Edmar Zanoteli
- Departamento de Neurologia, Universidade de São Paulo, Sao Paulo, SP, Brazil
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Finsterer J, Stöllberger C. Heart Disease in Disorders of Muscle, Neuromuscular Transmission, and the Nerves. Korean Circ J 2016; 46:117-34. [PMID: 27014341 PMCID: PMC4805555 DOI: 10.4070/kcj.2016.46.2.117] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 10/30/2015] [Accepted: 11/24/2015] [Indexed: 12/31/2022] Open
Abstract
Little is known regarding cardiac involvement (CI) by neuromuscular disorders (NMDs). The purpose of this review is to summarise and discuss the major findings concerning the types, frequency, and severity of cardiac disorders in NMDs as well as their diagnosis, treatment, and overall outcome. CI in NMDs is characterized by pathologic involvement of the myocardium or cardiac conduction system. Less commonly, additional critical anatomic structures, such as the valves, coronary arteries, endocardium, pericardium, and even the aortic root may be involved. Involvement of the myocardium manifests most frequently as hypertrophic or dilated cardiomyopathy and less frequently as restrictive cardiomyopathy, non-compaction, arrhythmogenic right-ventricular dysplasia, or Takotsubo-syndrome. Cardiac conduction defects and supraventricular and ventricular arrhythmias are common cardiac manifestations of NMDs. Arrhythmias may evolve into life-threatening ventricular tachycardias, asystole, or even sudden cardiac death. CI is common and carries great prognostic significance on the outcome of dystrophinopathies, laminopathies, desminopathies, nemaline myopathy, myotonias, metabolic myopathies, Danon disease, and Barth-syndrome. The diagnosis and treatment of CI in NMDs follows established guidelines for the management of cardiac disease, but cardiotoxic medications should be avoided. CI in NMDs is relatively common and requires complete work-up following the establishment of a neurological diagnosis. Appropriate cardiac treatment significantly improves the overall long-term outcome of NMDs.
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Affiliation(s)
| | - Claudia Stöllberger
- 2 Medical Department with Cardiology and Intensive Care Medicine, Krankenanstalt Rudolfstiftung, Vienna, Austria
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Fanin M, Angelini C. Protein and genetic diagnosis of limb girdle muscular dystrophy type 2A: The yield and the pitfalls. Muscle Nerve 2015; 52:163-73. [PMID: 25900067 DOI: 10.1002/mus.24682] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2015] [Indexed: 12/20/2022]
Abstract
Limb girdle muscular dystrophy type 2A (LGMD2A) is the most frequent form of LGMD worldwide. Comprehensive clinical assessment and laboratory testing is essential for diagnosis of LGMD2A. Muscle immunoblot analysis of calpain-3 is the most useful tool to direct genetic testing, as detection of calpain-3 deficiency has high diagnostic value. However, calpain-3 immunoblot testing lacks sensitivity in about 30% of cases due to gene mutations that inactivate the enzyme. The best diagnostic strategy should be determined on a case-by-case basis, depending on which tissues are available, and which molecular and/or genetic methods are adopted. In this work we survey the current knowledge, advantages, limitations, and pitfalls of protein testing and mutation detection in LGMD2A and provide an update of genetic epidemiology.
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Affiliation(s)
- Marina Fanin
- Department of Neurosciences, Biomedical Campus "Pietro d'Abano," via Giuseppe Orus 2B, 35129, Padova, Italy
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