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Zrelski MM, Hösele S, Kustermann M, Fichtinger P, Kah D, Athanasiou I, Esser PR, Wagner A, Herzog R, Kratochwill K, Goldmann WH, Kiritsi D, Winter L. Plectin Deficiency in Fibroblasts Deranges Intermediate Filament and Organelle Morphology, Migration, and Adhesion. J Invest Dermatol 2024; 144:547-562.e9. [PMID: 37716646 DOI: 10.1016/j.jid.2023.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 09/18/2023]
Abstract
Plectin, a highly versatile and multifunctional cytolinker, has been implicated in several multisystemic disorders. Most sequence variations in the human plectin gene (PLEC) cause epidermolysis bullosa simplex with muscular dystrophy (EBS-MD), an autosomal recessive skin-blistering disorder associated with progressive muscle weakness. In this study, we performed a comprehensive cell biological analysis of dermal fibroblasts from three different patients with EBS-MD, where PLEC expression analyses revealed preserved mRNA levels in all cases, whereas full-length plectin protein content was significantly reduced or completely absent. Downstream effects of pathogenic PLEC sequence alterations included massive bundling of vimentin intermediate filament networks, including the occurrence of ring-like nuclei-encasing filament bundles, elongated mitochondrial networks, and abnormal nuclear morphologies. We found that essential fibroblast functions such as wound healing, migration, or orientation upon cyclic stretch were significantly impaired in the cells of patients with EBS-MD. Finally, EBS-MD fibroblasts displayed reduced adhesion capacities, which could be attributed to smaller focal adhesion contacts. Our study not only emphasizes plectin's functional role in human skin fibroblasts, it also provides further insights into the understanding of EBS-MD-associated disease mechanisms.
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Affiliation(s)
- Michaela M Zrelski
- Department of Cell and Developmental Biology, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Sabrina Hösele
- Department of Cell and Developmental Biology, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Monika Kustermann
- Department of Cell and Developmental Biology, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Petra Fichtinger
- Department of Cell and Developmental Biology, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Delf Kah
- Center for Medical Physics and Technology, Department of Physics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ioannis Athanasiou
- Department of Dermatology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp R Esser
- Department of Dermatology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anja Wagner
- Core Facility Proteomics, Medical University of Vienna, Vienna, Austria; Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis, Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Austria
| | - Rebecca Herzog
- Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis, Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Austria
| | - Klaus Kratochwill
- Core Facility Proteomics, Medical University of Vienna, Vienna, Austria; Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis, Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Austria
| | - Wolfgang H Goldmann
- Center for Medical Physics and Technology, Department of Physics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Dimitra Kiritsi
- Department of Dermatology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lilli Winter
- Department of Cell and Developmental Biology, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.
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Wang R, Wang Y, Yan H, Wang H, Xie P. Cardiac involvement in muscular dystrophies: Role of myocardial perfusion imaging. Hell J Nucl Med 2024; 27:66-67. [PMID: 38629820 DOI: 10.1967/s002449912707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Technetium-99m-methoxy isobutyl isonitrile (99mTc-MIBI) myocardial perfusion imaging (MPI) is a functional imaging method with relatively poor specificity but high sensitivity. We present 48-year-old man with cardiac involvement due to muscular dystrophies (MD). Myocardial perfusion imaging rest images revealed regional myocardial perfusion decrease in multiple walls, enlarged heart and decreased left ventricular systolic function. The lesion location of MPI was consistent with that seen on CMR. Our case showed MPI was useful for detection and evaluation of the MD patient with cardiac involvement. In addition, imaging findings in combination with clinical history and other data are important. The case highlight is thevalue of MPI in myocardiopathy.
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Affiliation(s)
- Rong Wang
- Department of Nuclear Medicine, Gansu Provincial Hospital, Lanzhou 730000, China. ,
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3
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Martins IQ, Cuervo M, Vilhena I. Heart transplant anesthetic approach in a patient with Emery Dreyfuss muscular dystrophy: A case report. Rev Esp Anestesiol Reanim (Engl Ed) 2023; 70:540-544. [PMID: 37678464 DOI: 10.1016/j.redare.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/17/2022] [Indexed: 09/09/2023]
Abstract
Emery-Dreifuss muscular dystrophy is associated with cardiac abnormalities and rarely heart transplantation may be the treatment of choice. In this case, a male patient with Emery- Dreifuss muscular dystrophy developed NYHA class IV heart failure at 33 years of age and was submitted to heart transplantation. Anesthesia was adapted to prevent the development of malignant hyperthermia and rhabdomyolysis. The surgery was a success and the patient's progress was extremely positive with symptomatic improvement. In these patients, is critical to adjust not only his positioning but also the therapy administered in order to reduce iatrogeny and promote a faster recovery.
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Affiliation(s)
- I Q Martins
- Department of Anesthesiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - M Cuervo
- Department of Anesthesiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - I Vilhena
- Department of Anesthesiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Sabry S, Issa MY, Abdel-Hamid MS, Eissa NR, Abdel-Ghafar SF, Ibrahim MM, Zaki MS. An atypical expression of core α-Dystroglycan and Laminin-α2 in skin fibroblasts of patients with congenital muscular dystrophies. Mol Biol Rep 2023; 50:6373-6379. [PMID: 37318662 PMCID: PMC10374774 DOI: 10.1007/s11033-023-08500-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/28/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Congenital muscular dystrophies (CMDs) result from genetically inherited defects in the biosynthesis and/or the posttranslational modification (glycosylation) of laminin-α2 and α-dystroglycan (α-DG), respectively. The interaction between both proteins is responsible for the stability and integrity of the muscle cell. We aimed to study the expression profiles of both proteins in two classes of CMDs. SUBJECTS AND METHODS Whole-exome sequencing (WES) was done for four patients with neuromuscular manifestations. The expression of core α-DG and laminin-α2 subunit in skin fibroblasts and MCF-7 cells was assessed by western blot. RESULTS WES revealed two cases with nonsense mutations; c.2938G > T and c.4348 C > T, in LAMA2 encodes laminin-α2. It revealed also two cases with mutations in POMGNT1 encode protein O-mannose beta-1,2-N-acetylglucosaminyltransferase mutations. One patient had a missense mutation c.1325G > A, and the other had a synonymous variant c.636 C > T. Immunodetection of core α-DG in skin fibroblasts revealed the expression of truncated forms of core α-DG accompanied by reduced expression of laminin-α2 in POMGNT1-CMD patients and one patient with LAMA2-CMD. One patient with LAMA2-CMD had overexpression of laminin-α2 and expression of a low level of an abnormal form of increased molecular weight core α-DG. MCF-7 cells showed truncated forms of core α-CDG with an absent laminin-α2. CONCLUSION A correlation between the expression pattern/level of core α-DG and laminin-α2 could be found in patients with different types of CMD.
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Affiliation(s)
- Sahar Sabry
- Biochemical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre (NRC), Cairo, Egypt.
| | - Mahmoud Y Issa
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre (NRC), Cairo, Egypt
| | - Mohamed S Abdel-Hamid
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre (NRC), Cairo, Egypt
| | - Noura R Eissa
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre (NRC), Cairo, Egypt
| | - Sherif F Abdel-Ghafar
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre (NRC), Cairo, Egypt
| | - Mona M Ibrahim
- Biochemical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre (NRC), Cairo, Egypt
| | - Maha S Zaki
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre (NRC), Cairo, Egypt
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Abstract
PURPOSE OF REVIEW This review summarizes recent advances in our understanding of the genetics of rhabdomyolysis. RECENT FINDINGS Rhabdomyolysis is the acute breakdown of myofibres resulting in systemic changes that can be life-threatening. Environmental triggers, including trauma, exercise, toxins and infections, and/or gene defects can precipitate rhabdomyolysis. A schema (aptly titled RHABDO) has been suggested for evaluating whether a patient with rhabdomyolysis is likely to harbour an underlying genetic defect. It is becoming increasingly recognized that defects in muscular dystrophy and myopathy genes can trigger rhabdomyolysis, even as the sole or presenting feature. Variants in genes not previously associated with human disease have been identified recently as causative of rhabdomyolysis, MLIP , MYH1 and OBSCN . Our understanding of the pathomechanisms contributing to rhabdomyolysis have also improved with an increased awareness of the role of mitochondrial dysfunction in LPIN1 , FDX2 , ISCU and TANGO2 -mediated disease. SUMMARY An accurate genetic diagnosis is important for optimal clinical management of the patient, avoiding associated triggers and genetic counselling and cascade screening. Despite recent advances in our understanding of the genetics contributing to rhabdomyolysis, many patients remain without an accurate genetic diagnosis, suggesting there are many more causative genes, variants and disease mechanisms to uncover.
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Affiliation(s)
- Macarena Cabrera-Serrano
- Harry Perkins Institute of Medical Research
- Centre for Medical Research, University of Western Australia, Nedlands, Western Australia, Australia
- Unidad de Enfermedades Neuromusculares, Servicio de Neurologia y Neurofisiologia and Instituto de Biomedicina de Sevilla (IBiS)., Hospital Virgen del Rocio, Sevilla, Spain
| | - Gianina Ravenscroft
- Harry Perkins Institute of Medical Research
- Centre for Medical Research, University of Western Australia, Nedlands, Western Australia, Australia
- School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
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Ryuko T, Yamamoto H, Sugimoto S, Suzawa K, Miyoshi K, Otani S, Okazaki M, Yamane M, Toyooka S. Completely Video-assisted Thoracoscopic Lobectomy for Congenital Lobar Emphysema in a Young Adult. Acta Med Okayama 2022; 76:89-92. [PMID: 35237004 DOI: 10.18926/amo/63217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Congenital lobar emphysema (CLE) is defined as the hyperinflation of pulmonary lobes due to obstruction of the flow of air via a known or unknown etiology, which causes pressure symptoms in the adjacent organs. CLE is mainly diagnosed in the neonatal period, and very few adult cases have been reported. Here we report a 34-year-old male with muscular dystrophy who was diagnosed with CLE on examination. He underwent a right lower lobectomy via 3-portal completely video-assisted thoracoscopic surgery, and his symptoms improved. Thoracoscopic surgery helped preserve the respiratory muscles and led to the improvement of respiratory function in this patient.
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Affiliation(s)
- Tsuyoshi Ryuko
- Department of Thoracic Surgery, Okayama University Hospital
| | | | | | - Ken Suzawa
- Department of Thoracic Surgery, Okayama University Hospital
| | | | - Shinji Otani
- Department of Thoracic Surgery, Okayama University Hospital
| | - Mikio Okazaki
- Department of Thoracic Surgery, Okayama University Hospital
| | - Masaomi Yamane
- Department of Thoracic Surgery, Okayama University Hospital
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Coffey LN, Stephan CM, Zimmerman MB, Decker CK, Mathews KD. Diagnostic delay in patients with FKRP-related muscular dystrophy. Neuromuscul Disord 2021; 31:1235-1240. [PMID: 34857438 DOI: 10.1016/j.nmd.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/07/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022]
Abstract
Diagnostic journey for people with FKRP mutations participating in a dystroglycanopathy natural history study (n = 68; NCT00313677) was analyzed. Earliest symptoms and age at muscular dystrophy diagnosis were abstracted from subject-reported medical history and record review. Initial signs/symptoms were classified as chronic motor dysfunction (e.g., delayed motor milestones, weakness, falling; n = 40, 59%), elevated transaminases (n = 7, 10%), or acute/intermittent symptoms (myoglobinuria, myalgia, febrile illness-associated acute weakness; n = 21, 31%). Median time from sign/symptom onset to diagnosis was 6.5 years and differed by symptom group: 7.5 years for motor group, 9 years for acute/intermittent group, and 4 years for elevated transaminases group. The sign/symptom category that most commonly resulted in a diagnosis was chronic motor dysfunction (n = 45). Of those without clear weakness as first symptom (n = 55), 36.4% were not diagnosed with MD until weakness became apparent. Median time to diagnosis was shortest for those with febrile illness-associated acute weakness (0.25 years). Median time from first sign/symptom to MD diagnosis has decreased incrementally from 18.8 years for those with onset in the 1970s to < 10 years for symptom onset occurring after 2000. Awareness of disease presentation variability will aid in earlier diagnosis, which is increasingly important with treatments in development.
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Affiliation(s)
- Lauren N Coffey
- University of Iowa Carver College of Medicine, 375 Newton Rd, Iowa City, IA 52242, USA.
| | - Carrie M Stephan
- Department of Pediatrics, University of Iowa Carver College of Medicine, 200 Hawkins Drive Iowa City, IA 52242, USA
| | - M B Zimmerman
- Department of Biostatistics, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, USA
| | - Chyan K Decker
- Department of Pediatrics, University of Iowa Carver College of Medicine, 200 Hawkins Drive Iowa City, IA 52242, USA
| | - Katherine D Mathews
- Department of Pediatrics, University of Iowa Carver College of Medicine, 200 Hawkins Drive Iowa City, IA 52242, USA; Department of Neurology, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA
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Matsumura T, Inoue K, Toyooka K, Inoue M, Iida A, Saito Y, Nishikawa T, Moriuchi K, Beck G, Nishino I, Fujimura H. Clinical trajectory of a patient with filaminopathy who developed arrhythmogenic cardiomyopathy, myofibrillar myopathy, and multiorgan tumors. Neuromuscul Disord 2021; 31:1282-1286. [PMID: 34857437 DOI: 10.1016/j.nmd.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 08/05/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022]
Abstract
We report a case of a patient presenting with arrhythmogenic cardiomyopathy, myofibrillar myopathy, and multiorgan tumors. A 41-year-old woman with a history of hypertrophic cardiomyopathy, diagnosed at 6 years of age, developed scoliosis after puberty. Following spinal surgery to address the scoliosis, she developed recurrent severe arrhythmia and heart failure. She developed hypoventilation at age 29 years. Proximal dominant weakness and mild elevation of serum creatine kinase indicated possible myopathy. Myofibrillar myopathy was diagnosed by muscle biopsy at age 30 year. Acute abdomen was repeatedly reported from age 33 years, eventually leading to a diagnosis of gastric polyp and erosive ulcer. A urinary bladder tumor was found at age 35 years, and breast cancer was diagnosed at age 40 years. Whole exome sequencing detected a heterozygous missense mutation in Filamin C. Recent evidences suggest that filamins are associated with tumors, and this case further highlights the clinical spectrum of filaminopathy.
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Affiliation(s)
- Tsuyoshi Matsumura
- Department of Neurology, National Hospital Organization Osaka Toneyama Medical Center, Toneyama 5-1-1, Toyonaka, Osaka 560-8552, Japan.
| | - Kimiko Inoue
- Department of Neurology, National Hospital Organization Osaka Toneyama Medical Center, Toneyama 5-1-1, Toyonaka, Osaka 560-8552, Japan
| | - Keiko Toyooka
- Department of Neurology, National Hospital Organization Osaka Toneyama Medical Center, Toneyama 5-1-1, Toyonaka, Osaka 560-8552, Japan
| | - Michio Inoue
- Department of Neuromuscular Research, National Center of Neurology, Psychiatry, Ogawahigashi 4-1-1, Kodaira, Tokyo 187-8551, Japan
| | - Aritoshi Iida
- Department of Neuromuscular Research, National Center of Neurology, Psychiatry, Ogawahigashi 4-1-1, Kodaira, Tokyo 187-8551, Japan
| | - Yoshihiko Saito
- Department of Neuromuscular Research, National Center of Neurology, Psychiatry, Ogawahigashi 4-1-1, Kodaira, Tokyo 187-8551, Japan
| | - Tatsuya Nishikawa
- Department of Onco-Cardiology, Osaka International Cancer Institute, Otemae 3-1-69, Chuo-ku, Osaka City, Osaka, 541-8567, Japan
| | - Kenji Moriuchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Kishibe-Shinmachi 6-1, Suita, Osaka 564-8565, Japan
| | - Goichi Beck
- Department of Neurology, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita, Osaka 565-0871, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Center of Neurology, Psychiatry, Ogawahigashi 4-1-1, Kodaira, Tokyo 187-8551, Japan
| | - Harutoshi Fujimura
- Department of Neurology, National Hospital Organization Osaka Toneyama Medical Center, Toneyama 5-1-1, Toyonaka, Osaka 560-8552, Japan
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Nguyen TH, Conotte S, Belayew A, Declèves AE, Legrand A, Tassin A. Hypoxia and Hypoxia-Inducible Factor Signaling in Muscular Dystrophies: Cause and Consequences. Int J Mol Sci 2021; 22:7220. [PMID: 34281273 PMCID: PMC8269128 DOI: 10.3390/ijms22137220] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022] Open
Abstract
Muscular dystrophies (MDs) are a group of inherited degenerative muscle disorders characterized by a progressive skeletal muscle wasting. Respiratory impairments and subsequent hypoxemia are encountered in a significant subgroup of patients in almost all MD forms. In response to hypoxic stress, compensatory mechanisms are activated especially through Hypoxia-Inducible Factor 1 α (HIF-1α). In healthy muscle, hypoxia and HIF-1α activation are known to affect oxidative stress balance and metabolism. Recent evidence has also highlighted HIF-1α as a regulator of myogenesis and satellite cell function. However, the impact of HIF-1α pathway modifications in MDs remains to be investigated. Multifactorial pathological mechanisms could lead to HIF-1α activation in patient skeletal muscles. In addition to the genetic defect per se, respiratory failure or blood vessel alterations could modify hypoxia response pathways. Here, we will discuss the current knowledge about the hypoxia response pathway alterations in MDs and address whether such changes could influence MD pathophysiology.
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Affiliation(s)
- Thuy-Hang Nguyen
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
| | - Stephanie Conotte
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
| | - Alexandra Belayew
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
| | - Anne-Emilie Declèves
- Department of Metabolic and Molecular Biochemistry, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium;
| | - Alexandre Legrand
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
| | - Alexandra Tassin
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
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10
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Roney JC, Li S, Farfel-Becker T, Huang N, Sun T, Xie Y, Cheng XT, Lin MY, Platt FM, Sheng ZH. Lipid-mediated motor-adaptor sequestration impairs axonal lysosome delivery leading to autophagic stress and dystrophy in Niemann-Pick type C. Dev Cell 2021; 56:1452-1468.e8. [PMID: 33878344 PMCID: PMC8137671 DOI: 10.1016/j.devcel.2021.03.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/28/2021] [Accepted: 03/28/2021] [Indexed: 01/18/2023]
Abstract
Niemann-Pick disease type C (NPC) is a neurodegenerative lysosomal storage disorder characterized by lipid accumulation in endolysosomes. An early pathologic hallmark is axonal dystrophy occurring at presymptomatic stages in NPC mice. However, the mechanisms underlying this pathologic change remain obscure. Here, we demonstrate that endocytic-autophagic organelles accumulate in NPC dystrophic axons. Using super-resolution and live-neuron imaging, we reveal that elevated cholesterol on NPC lysosome membranes sequesters kinesin-1 and Arl8 independent of SKIP and Arl8-GTPase activity, resulting in impaired lysosome transport into axons, contributing to axonal autophagosome accumulation. Pharmacologic reduction of lysosomal membrane cholesterol with 2-hydroxypropyl-β-cyclodextrin (HPCD) or elevated Arl8b expression rescues lysosome transport, thereby reducing axonal autophagic stress and neuron death in NPC. These findings demonstrate a pathological mechanism by which altered membrane lipid composition impairs lysosome delivery into axons and provide biological insights into the translational application of HPCD in restoring axonal homeostasis at early stages of NPC disease.
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Affiliation(s)
- Joseph C Roney
- Synaptic Function Section, The Porter Neuroscience Research Center, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Room 2B-215, 35 Convent Drive, Bethesda, MD 20892-3706, USA; Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK
| | - Sunan Li
- Synaptic Function Section, The Porter Neuroscience Research Center, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Room 2B-215, 35 Convent Drive, Bethesda, MD 20892-3706, USA
| | - Tamar Farfel-Becker
- Synaptic Function Section, The Porter Neuroscience Research Center, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Room 2B-215, 35 Convent Drive, Bethesda, MD 20892-3706, USA
| | - Ning Huang
- Synaptic Function Section, The Porter Neuroscience Research Center, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Room 2B-215, 35 Convent Drive, Bethesda, MD 20892-3706, USA
| | - Tao Sun
- Synaptic Function Section, The Porter Neuroscience Research Center, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Room 2B-215, 35 Convent Drive, Bethesda, MD 20892-3706, USA
| | - Yuxiang Xie
- Synaptic Function Section, The Porter Neuroscience Research Center, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Room 2B-215, 35 Convent Drive, Bethesda, MD 20892-3706, USA
| | - Xiu-Tang Cheng
- Synaptic Function Section, The Porter Neuroscience Research Center, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Room 2B-215, 35 Convent Drive, Bethesda, MD 20892-3706, USA
| | - Mei-Yao Lin
- Synaptic Function Section, The Porter Neuroscience Research Center, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Room 2B-215, 35 Convent Drive, Bethesda, MD 20892-3706, USA
| | - Frances M Platt
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK
| | - Zu-Hang Sheng
- Synaptic Function Section, The Porter Neuroscience Research Center, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Room 2B-215, 35 Convent Drive, Bethesda, MD 20892-3706, USA.
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Abstract
Late-onset myopathies are not well-defined since there is no clear definition of 'late onset'. For practical reasons we decided to use the age of 40 years as a cut-off. There are diseases which only manifest as late onset myopathy (inclusion body myositis, oculopharyngeal muscular dystrophy and axial myopathy). In addition, there are diseases with a wide range of onset including 'late onset' muscle weakness. Well-known and rather frequently occurring examples are Becker muscular dystrophy, limb girdle muscular dystrophy, facioscapulohumeral dystrophy, Pompe disease, myotonic dystrophy type 2, and anoctamin-5-related distal myopathy. The above-mentioned diseases will be discussed in detail including clinical presentation - which can sometimes lead someone astray - and diagnostic tools based on real cases taken from the author's practice. Where appropriate a differential diagnosis is provided. Next generation sequencing (NGS) may speed up the diagnostic process in hereditary myopathies, but still there are diseases, e.g. with expansion repeats, deletions, etc, in which NGS is as yet not very helpful.
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Affiliation(s)
- Marianne de Visser
- Department of Neurology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
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12
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De Paepe B. Progressive Skeletal Muscle Atrophy in Muscular Dystrophies: A Role for Toll-like Receptor-Signaling in Disease Pathogenesis. Int J Mol Sci 2020; 21:ijms21124440. [PMID: 32580419 PMCID: PMC7352931 DOI: 10.3390/ijms21124440] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/18/2020] [Accepted: 06/18/2020] [Indexed: 12/16/2022] Open
Abstract
Muscle atrophy is an active process controlled by specific transcriptional programs, in which muscle mass is lost by increased protein degradation and/or decreased protein synthesis. This review explores the involvement of Toll-like receptors (TLRs) in the muscle atrophy as it is observed in muscular dystrophies, disorders characterized by successive bouts of muscle fiber degeneration and regeneration in an attempt to repair contraction-induced damage. TLRs are defense receptors that detect infection and recognize self-molecules released from damaged cells. In muscular dystrophies, these receptors become over-active, and are firmly involved in the sustained chronic inflammation exhibited by the muscle tissue, via their induction of pro-inflammatory cytokine expression. Taming the exaggerated activation of TLR2/4 and TLR7/8/9, and their downstream effectors in particular, comes forward as a therapeutic strategy with potential to slow down disease progression.
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Valari M, Theodoraki M, Loukas I, Gkantseva-Patsoura S, Karavana G, Falaina V, Lykopoulou L, Pons R, Athanasiou I, Wertheim-Tysarowska K, Kanaka-Gantenbein C, Kiritsi D. Novel PLEC Variant Causes Mild Skin Fragility, Pyloric Atresia, Muscular Dystrophy and Urological Manifestations. Acta Derm Venereol 2019; 99:1309-1310. [PMID: 31513275 DOI: 10.2340/00015555-3317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Manthoula Valari
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens
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Arnedo Hernández S, Mosquera Lozano JD, Martínez de Narvajas Urra I, Menéndez Fernández E, Rabadán Pejenaute E, Baeza Trinidad R, Casañas Martínez M, Brea Hernando A. iPCSK9 treatment of Familial Hypercholesterolemia in a patient diagnosed as Congenital Muscular Dystrophy with contraindication for statin use. Clin Investig Arterioscler 2019; 31:278-281. [PMID: 30979437 DOI: 10.1016/j.arteri.2019.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/21/2019] [Accepted: 01/24/2019] [Indexed: 06/09/2023]
Abstract
Statins are contraindicated in patients with myopathies. Until a few years ago, in those patients with Familial Hypercholesterolemia who also presented muscular dystrophies and didńt reach adequate cholesterol plasmatic levels, the next therapeutic ladder was lipoapheresis. When iPCSK9 first appeared, lipoapheresis could be suspended in some of these patients, sustaining nevertheless proper levels of cholesterol. We present the case of a 27 year-old male, diagnosed with Congenital Muscular Dystrophy in the early childhood. He was referred to the Unit of Lipidology presenting hypercholesterolemia which, after genetic test, was assessed as Heterozygous Familial Hypercholesterolemia. Despite of treatment with diet and ezetimibe, cLDL blood levels abide high, being consequently included in lipoapheresis programme, therewith obtained levels of cLDL of 70mg/dl. In providing iPCSK9, lipoapheresis was withdrawn and treatment with alirocumab 150mg fortnightly introduced, unveiling a positive response, and sustaining cLDL levels around 75mg/dl.
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Affiliation(s)
- Sergio Arnedo Hernández
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital San Pedro, Logroño, La Rioja, España.
| | | | | | | | - Elisa Rabadán Pejenaute
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital San Pedro, Logroño, La Rioja, España
| | - Ramón Baeza Trinidad
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital San Pedro, Logroño, La Rioja, España
| | - Marta Casañas Martínez
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital San Pedro, Logroño, La Rioja, España
| | - Angel Brea Hernando
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital San Pedro, Logroño, La Rioja, España
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Majewski J, Varma M, Davis G, Lelakowski J. Disease-specific aspects of management of cardiac arrhythmias in patients with muscular dystrophies. Pol Merkur Lekarski 2019; 47:153-156. [PMID: 31760399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cardiac arrhythmias are common in patients with various types of muscular dystrophies. The pathophysiological mechanisms of arrhythmias are complex and related to direct involvement of the conduction system and to the development of cardiomyopathy. The occurrence of atrio-ventricular conduction abnormalities and ventricular arrhythmias are associated with increased risk of sudden cardiac death. The threshold for device therapy ( cardiac pacemaker, implantable cardioverter defibrillator) is relatively low according to current guidelines due to the risk of rapid progression of the disease. Atrial arrhythmias carry high risk of stroke and anticoagulation should be considered even in young patients without coexisting risk factors for stroke as estimated by the CHA2DS2-VASc score. Patients with muscular dystrophies should be under regular cardiology follow up even in the absence of symptoms. Early detection of cardiac involvement is crucial. The management of patients with muscular dystrophies requires disease-specific and multidisciplinary approach due to the multi-organ involvement.
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Affiliation(s)
| | | | - Gershan Davis
- Academic Cardiovascular Group, University of Central Lancashire, Preston, UK
| | - Jacek Lelakowski
- Department of Electrocardiololgy, Institute of Cardiology Medical College Jagiellonian University, Krakow, Poland
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16
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Iwata Y, Matsumura T. Blockade of TRPV2 is a Novel Therapy for Cardiomyopathy in Muscular Dystrophy. Int J Mol Sci 2019; 20:ijms20163844. [PMID: 31394715 PMCID: PMC6720432 DOI: 10.3390/ijms20163844] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/16/2019] [Accepted: 08/02/2019] [Indexed: 12/17/2022] Open
Abstract
Muscular dystrophy and dilated cardiomyopathy are intractable diseases and their treatment options are very limited. Transient receptor potential cation channel subfamily V, member 2 (TRPV2), is a stretch-sensitive Ca2+-permeable channel that causes sustained intracellular Ca2+ increase in muscular cells, which is a pathophysiological feature of degenerative muscular disease. Recent reports have clarified that TRPV2 is concentrated and activated in the sarcolemma of cardiomyocytes/myocytes during cardiomyopathy/heart failure and muscular dystrophy. Furthermore, these reports showed that inactivation of TRPV2 ameliorates muscle dysgenesis to improve cardiac function and survival prognosis. Although TRPV2 is a potential therapeutic target for cardiomyopathy, there were no TRPV2 inhibitors available until recently. In this review, we introduce our recent findings and discuss the current progress in the development of TRPV2 inhibitors and their therapeutic applications for cardiomyopathy associated with muscular dystrophy.
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Affiliation(s)
- Yuko Iwata
- Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, 6-1 Kishibe Shinmachi, Suita, Osaka 564-8565, Japan
| | - Tsuyoshi Matsumura
- Department of Neurology, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka 560-8552, Japan.
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Printza A, Goutsikas C, Triaridis S, Kyrgidis A, Haidopoulou K, Constantinidis J, Pavlou E. Dysphagia diagnosis with questionnaire, tongue strength measurement, and FEES in patients with childhood-onset muscular dystrophy. Int J Pediatr Otorhinolaryngol 2019; 117:198-203. [PMID: 30579082 DOI: 10.1016/j.ijporl.2018.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/02/2018] [Accepted: 12/03/2018] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Dysphagia in progressive muscle diseases is primarily due to muscle weakness. Objective of our study is to investigate the prevalence and phenotypes of dysphagia in patients with childhood onset muscular dystrophy (MD) with the use of a validated questionnaire, the measurement of tongue strength and Flexible Endoscopic Evaluation of Swallowing (FEES). METHODS Prospective observational longitudinal study of dysphagia in a cohort of 58 patients attending the Pediatric Department Center for Neuromuscular Diseases. Control participants were 56 age and sex matched healthy volunteers. Dysphagia was evaluated with the Eating Assessment Tool-10 (EAT-10), and the measurement of Maximal Isometric Tongue Pressure (MITP) and tongue endurance (Iowa Oral Performance Instrument-IOPI). Dysphagic patients were submitted to FEES. Recorded data included demographic and anthropometric characteristics, type of MD, feeding status, and spirometry. RESULTS Our patients' cohort consisted of 41 children, 11 adolescents, and 6 adults. Based on EAT-10, 20.7% of the patients were dysphagic: 14.63% of children, 27.3% of adolescents and 50% of adults. The main complain was solid food dysphagia. Spirometry parameters mean values for children and adolescent patients corresponded to lower than the fifth percentile. Means of FVC and FEV1 expressed as % predicted for adult patients were 27.8 (SD:25.05) and 28.8 (SD:28.44) respectively. Reduced tongue strength was measured to children aged 9-10, adolescent and adult MD patients. The main FEES findings were pharyngeal residue, spillage of food before the swallow, and supraglottal penetration. DISCUSSION This is the first study to use a validated questionnaire to evaluate dysphagia in childhood onset MD and report dyphagia prevalence at different patients' age. This is the first study reporting MITP in children and adults with generalised MD. Tongue pressures are reduced well before clinical signs of dysphagia are present. CONCLUSION Screening of potentially dysphagic MD patients can be based on a validated questionnaire. Patients with an EAT-10 score suggestive of dysphagia at regular follow-up can have the MITP measured and in the case of reduced values a thorough dysphagia evaluation with FEES is indicated.
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Affiliation(s)
- Athanasia Printza
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Greece.
| | - Charalambos Goutsikas
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Greece.
| | - Stefanos Triaridis
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Greece.
| | - Athanasios Kyrgidis
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Greece.
| | - Katerina Haidopoulou
- 2nd Paediatric Department, Center for Neuromuscular Diseases, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, Greece.
| | - Jannis Constantinidis
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Greece.
| | - Evagelos Pavlou
- 2nd Paediatric Department, Center for Neuromuscular Diseases, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, Greece.
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18
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Petrangelo A, Alshehri E, Czuzoj-Shulman N, Abenhaim HA. Obstetrical, maternal and neonatal outcomes in pregnancies affected by muscular dystrophy. J Perinat Med 2018; 46:791-796. [PMID: 29924738 DOI: 10.1515/jpm-2017-0299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/03/2018] [Indexed: 12/28/2022]
Abstract
Abstract
Objective:
Pregnancies in women affected by a muscular dystrophy are at an increased risk of adverse maternal and neonatal outcomes due to the effect of the disease on the muscular, cardiac and respiratory systems. We sought to evaluate the risk of adverse outcomes within a large population-based cohort study.
Methods:
We used the data extracted from the Nationwide Inpatient Sample (NIS) to conduct a retrospective population-based cohort study consisting of over 12 million births that occurred in the United States between 1999 and 2013. Births to mothers with muscular dystrophy were identified using the International Classification of Diseases, Ninth Revision (ICD-9) codes and were compared with births to mothers with no maternal muscular dystrophy. Unconditional logistic regression analysis was used to evaluate the adjusted effect of muscular dystrophy on maternal and neonatal outcomes.
Results:
During the 14-year study period, there was an increasing trend in the incidence of muscular dystrophy, with a cumulative incidence of 7.26 in 100,000 births. Women with muscular dystrophy and their neonates were at a significantly increased risk of adverse pregnancy outcomes: specifically, an increased risk of preeclampsia, preterm premature rupture of membranes, preterm labor, venous thromboembolism, cardiac dysrhythmia, requiring a blood transfusion and giving birth by cesarean section. Neonates born to affected mothers were at a significantly higher risk of being born preterm, with a congenital malformation and suffering intrauterine growth restriction.
Conclusion:
The risk of several adverse maternal and neonatal outcomes is increased in pregnant women with muscular dystrophy. As such, additional surveillance in order to mitigate the risk of adverse outcomes is warranted in these pregnancies.
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Affiliation(s)
- Adriano Petrangelo
- Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Eman Alshehri
- Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Nicholas Czuzoj-Shulman
- Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada
| | - Haim A Abenhaim
- Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
- Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada
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Al-Thawabieh W, Lucky AW, Wong B, Motley WW. Pediatric Ophthalmoplegia and Ptosis in Epidermolysis Bullosa Simplex Associated With Muscular Dystrophy. J Pediatr Ophthalmol Strabismus 2018; 55:e26-e29. [PMID: 30180241 DOI: 10.3928/01913913-20180806-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 07/23/2018] [Indexed: 11/20/2022]
Abstract
Oculomotor dysfunction in epidermolysis bullosa simplex associated with muscular dystrophy has been reported rarely in the ophthalmic literature. In a series of 6 patients with epidermolysis bullosa simplex associated with muscular dystrophy, 3 demonstrated ptosis, ophthalmoplegia, or both. Ptosis and ophthalmoplegia may occur early in epidermolysis bullosa simplex associated with muscular dystrophy and aid in diagnosis. [J Pediatr Ophthalmol Strabismus. 2018;55:e26-e29.].
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20
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Fossmo HL, Holtebekk E, Giltvedt K, Dybesland AR, Sanaker PS, Ørstavik K. Physical exercise in adults with hereditary neuromuscular disease. Tidsskr Nor Laegeforen 2018; 138:17-1024. [PMID: 29947206 DOI: 10.4045/tidsskr.17.1024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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21
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Abstract
Objective Heart failure is currently the most serious complication of muscular dystrophy. The transient receptor potential cation channel, subfamily V, member 2 (TRPV2) is a stretch-sensitive Ca channel. In damaged myocytes or cardiomyocytes, TRPV2 translocates to the cytoplasmic membrane and enhances Ca influx, triggering cell damage. Evidence suggests that the inhibition of TRPV2 may be a new therapeutic target in heart failure. We found that tranilast, which is widely used as an anti-allergic drug, inhibits TRPV2. A pilot study was conducted to assess the safety and efficacy of tranilast in muscular dystrophy patients with cardiomyopathy. Methods After obtaining informed consent, two muscular dystrophy patients with advanced heart failure took tranilast (300 mg/day) for three months. Blood tests, echocardiography, electrocardiography (ECG), Holter ECG, analyses of the TRPV2 expression in peripheral mononuclear cells, and circulating micro ribonucleic acid profiling were performed to assess the safety and efficacy of tranilast. Results The brain natriuretic peptide levels decreased after treatment. The expression of TRPV2 on the cytoplasmic membrane of peripheral mononuclear cells was enhanced before treatment and was decreased after treatment. Some heart-related micro ribonucleic acids (miR-208a-5p, miR-223-3p) were elevated and then decreased after treatment. Some adverse events, including the potentiation of warfarin, the worsening of renal dysfunction, an increased heart rate and premature ventricular contractions, were observed. Conclusion Tranilast can inhibit TRPV2 and can be effective for treating heart failure, even in patients with muscular dystrophy. Although careful attention is needed, the inhibition of TRPV2 can be a new treatment target for cardiomyopathy. A multi-center trial is planned.
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Affiliation(s)
- Tsuyoshi Matsumura
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Japan
| | - Misa Matsui
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Japan
| | - Yuko Iwata
- Department of Molecular Physiology, National Cerebral and Cardiovascular Center Research Institute, Japan
| | - Masanori Asakura
- Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, Japan
| | - Toshio Saito
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Japan
| | - Harutoshi Fujimura
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Japan
| | - Saburo Sakoda
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Japan
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22
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Hasselberg NE, Berge KE, Rasmussen M, Früh A, Ørstavik K, Haugaa KH. [Cardiomyopathy in hereditary muscular dystrophies]. Tidsskr Nor Laegeforen 2018; 138:16-0683. [PMID: 29313627 DOI: 10.4045/tidsskr.16.0683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
MESH Headings
- Arrhythmias, Cardiac/diagnosis
- Arrhythmias, Cardiac/etiology
- Arrhythmias, Cardiac/genetics
- Cardiomyopathies/diagnosis
- Cardiomyopathies/etiology
- Cardiomyopathies/genetics
- Electrocardiography
- Humans
- Muscle Cells/physiology
- Muscular Dystrophies/complications
- Muscular Dystrophies/congenital
- Muscular Dystrophies/diagnosis
- Muscular Dystrophies/genetics
- Muscular Dystrophies, Limb-Girdle/complications
- Muscular Dystrophies, Limb-Girdle/congenital
- Muscular Dystrophies, Limb-Girdle/diagnosis
- Muscular Dystrophies, Limb-Girdle/genetics
- Muscular Dystrophy, Duchenne/complications
- Muscular Dystrophy, Duchenne/congenital
- Muscular Dystrophy, Duchenne/diagnosis
- Muscular Dystrophy, Duchenne/genetics
- Muscular Dystrophy, Emery-Dreifuss/complications
- Muscular Dystrophy, Emery-Dreifuss/congenital
- Muscular Dystrophy, Emery-Dreifuss/diagnosis
- Muscular Dystrophy, Emery-Dreifuss/genetics
- Myotonic Dystrophy/complications
- Myotonic Dystrophy/diagnosis
- Myotonic Dystrophy/genetics
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MARTINS ANAINÊS, MAARQUE CRISTIN, PINTO-BASTO JORGE, NEGRÃO LUIS. Bethlem myopathy in a Portuguese patient - case report. Acta Myol 2017; 36:178-181. [PMID: 29774307 PMCID: PMC5953228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Mutations of the encoding genes of collagen VI (COL6A1, COL6A2 and COL6A3), are responsible for two classical phenotypes (with a wide range of severity), the Ullrich congenital muscular dystrophy (UCMD) and the Bethlem myopathy (BM). We present a male patient of 49 years old, with symptoms of muscle weakness beginning in childhood and of very slowly progression. At the age of 42, the neurological examination revealed proximal lower limb muscle weakness and contractures of fingers flexors muscles, positive Gowers manoeuvre and a waddling gait. Serum creatine kinase (CK) values were slightly elevated, electromyographic study revealed myopathic changes and muscle MRI of the lower limbs showed a specific pattern of muscle involvement, with peripheral fat infiltration in vastus lateralis and intermedius and anterocentral infiltration in rectus femoris. Respiratory and cardiac functions were unremarkable. Whole exome sequencing identified the homozygous mutation c.1970-9G>A in COL6A2 gene.
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Affiliation(s)
- ANA INÊS MARTINS
- Neuromuscular Disease Unit, Neurology Department, Coimbra University and Hospital Center, Coimbra, Portugal
| | - CRISTIN MAARQUE
- Neuromuscular Disease Unit, Neurology Department, Coimbra University and Hospital Center, Coimbra, Portugal
| | - JORGE PINTO-BASTO
- Neuromuscular Disease Unit, Neurology Department, Coimbra University and Hospital Center, Coimbra, Portugal
| | - LUIS NEGRÃO
- Neuromuscular Disease Unit, Neurology Department, Coimbra University and Hospital Center, Coimbra, Portugal
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Echeverría C, Diaz A, Suarez B, Bevilacqua JA, Bonnemann C, Bertini E, Castiglioni C. Keloids, Spontaneous or After Minor Skin Injury: Importance of Not Missing Bethlem Myopathy. Acta Derm Venereol 2017; 97:297-298. [PMID: 27563703 DOI: 10.2340/00015555-2523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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25
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Vitaliti G, Pavone P, Romano C, Barbagallo M, Vecchio M, Ledda C, Lubrano R, Falsaperla R. Congenital muscular dystrophy and epilepsy: a prospective case series of pediatric patients. J BIOL REG HOMEOS AG 2016; 30:1217-1221. [PMID: 28078877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Congenital Muscular Dystrophies (CMDs) can be considered as a heterogeneous group of diseases characterized by marked weakness, generalized hypotonia and joint contractures. They are divided into pure and classical forms, without ocular and cerebral involvement, and complex forms, which are associated with cerebral abnormalities. Seizures have rarely been described in the pure forms while they seem to occur more frequently in complex forms. The aim of our study was to evaluate the incidence of seizure in CMD. Herein, the authors describe 16 cases of congenital muscular dystrophy (CMD) associated with different kinds of epileptic events, in order to study the pathogenic connection between the two clinical manifestations. In all described patients we reviewed the clinical, neurophysiologic, and neuroimaging data to determine any associations with epilepsy. The patients were divided into two groups: 14 cases with merosin positive CMD in one group and 2 patients with Walker Warburg syndrome (WWS) in the second group. In our study we found that in the first group, one benign myoclonic epilepsy (BME), one benign febrile convulsions had occurred. Also in one patient, the EEG revealed a moderately high voltage slow background with diffuse sharp waves reaching 300mV in amplitude with no clinical signs. In the merosin positive CMD patients, the presence of two different epileptic diseases, benign myoclonic epilepsy (BME) in one and febrile convulsion with tonic clinic seizures, may represent a new expression of merosine-positive congenital muscular disease (PCMD) in which the deficiency of an undiscovered muscular protein with a cerebral isoform may be the cause of epileptic events in this group of patients.
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Affiliation(s)
- G Vitaliti
- General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy
| | - P Pavone
- General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy
| | - C Romano
- General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy
| | - M Barbagallo
- General Paediatrics O.U., Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, Italy
| | - M Vecchio
- Centre of Physical Medicine and Rehabilitation, Policlinico-Vittorio Emanuele Hospital, University of Catania, Italy
| | - C Ledda
- Clinical Pathology Unit, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, Italy
| | - R Lubrano
- Pediatric Department, Pediatric Nephrology Operative Unit of Sapienza University of Rome, Rome, Italy
| | - R Falsaperla
- General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy
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26
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Smith AE, Molton IR, Jensen MP. Self-reported incidence and age of onset of chronic comorbid medical conditions in adults aging with long-term physical disability. Disabil Health J 2016; 9:533-8. [PMID: 27009420 DOI: 10.1016/j.dhjo.2016.02.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 01/29/2016] [Accepted: 02/06/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Adults with long-term disability are living longer and may experience accelerated aging. More information is needed to understand the incidence of chronic comorbid medical conditions in this population. OBJECTIVE To examine the incidence, prevalence, age of onset and predictors of five chronic conditions in a sample of adults with long-term physical disability. METHODS Longitudinal self-report surveys were mailed to 1594 adults with multiple sclerosis, muscular dystrophy, post-polio syndrome or spinal cord injury twice, 3.5 years apart. Survey questions assessed demographics (date of birth, sex, income, disability type, height/weight), self-reported diagnosis of coronary heart disease, hypertension, arthritis, diabetes and cancer, and health behaviors (alcohol use, smoking, physical activity). RESULTS Over the course of the study, the most commonly reported new onset chronic comorbid medical condition was arthritis (percent incidence = 14%), followed by hypertension (9%) and cancer (7%). Report of a new condition was greatest in adults aged between 56 and 65 years, and risk factors included greater BMI, waist circumference, and the presence of another chronic comorbid medical condition at baseline. CONCLUSIONS Chronic comorbid medical conditions are prevalent in persons with long-term physical disability. Midlife appears to be the period of greatest risk for onset of a new condition, and risk for incidence increases in the presence of other chronic comorbid medical conditions. Modifiable risk factors include BMI and waist circumference. Future research should explore whether changes in modifiable factors at midlife or earlier (e.g., diet, exercise) would help prevent or delay onset of comorbid conditions in this population.
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Affiliation(s)
- Amanda E Smith
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA.
| | - Ivan R Molton
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA
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Hashimoto M, Sakaguchi H, Sadanaga M. [Anesthetic Management for Endoscopic Sinus Surgery in a Patient with Transplanted Heart--A Case Report]. Masui 2015; 64:160-163. [PMID: 26121809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 19-year-old male patient with transplanted heart received endoscopic sinus surgery. He was with X-linked dilated cardiomyopathy, and was one year after the transplantation. Preanesthetic study showed lactate dehydrogenase elevation estimated to have derived from striated muscle. Heart function was normal, and other abnormal findings were not revealed. Total intravenous anesthesia was performed with propofol target controlled infusion and remifentanil. Rocuronium was administered only for oro-tracheal ntubation. After the operation, train-of-four ratio was 95%, and he awoke from anesthesia smoothly. We did not use atropine, neostigmine or sugammadex to reverse neuromuscular blockade. No inotropic agent was administered. He was discharged from the hospital 5 days after the operation without any complications. We used usual anesthetic management but we had to be careful about both denervated heart and myopathy.
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Goodrich E, Wahbeh H, Mooney A, Miller M, Oken BS. Teaching mindfulness meditation to adults with severe speech and physical impairments: An exploratory study. Neuropsychol Rehabil 2014; 25:708-32. [PMID: 25338503 PMCID: PMC4408202 DOI: 10.1080/09602011.2014.970201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
People with severe speech and physical impairments may benefit from mindfulness meditation training because it has the potential to enhance their ability to cope with anxiety, depression and pain and improve their attentional capacity to use brain-computer interface systems. Seven adults with severe speech and physical impairments (SSPI) - defined as speech that is understood less than 25% of the time and/or severely reduced hand function for writing/typing - participated in this exploratory, uncontrolled intervention study. The objectives were to describe the development and implementation of a six-week mindfulness meditation intervention and to identify feasible outcome measures in this population. The weekly intervention was delivered by an instructor in the participant's home, and participants were encouraged to practise daily using audio recordings. The objective adherence to home practice was 10.2 minutes per day. Exploratory outcome measures were an n-back working memory task, the Attention Process Training-II Attention Questionnaire, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale, the Positive and Negative Affect Schedule, and a qualitative feedback survey. There were no statistically significant pre-post results in this small sample, yet administration of the measures proved feasible, and qualitative reports were overall positive. Obstacles to teaching mindfulness meditation to persons with SSPI are reported, and solutions are proposed.
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Affiliation(s)
- Elena Goodrich
- a Department of Neurology , Oregon Health & Science University , Portland , OR , USA
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Villa CR, Ryan TD, Collins JJ, Taylor MD, Lucky AW, Jefferies JL. Left ventricular non-compaction cardiomyopathy associated with epidermolysis bullosa simplex with muscular dystrophy and PLEC1 mutation. Neuromuscul Disord 2014; 25:165-8. [PMID: 25454730 DOI: 10.1016/j.nmd.2014.09.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/14/2014] [Accepted: 09/25/2014] [Indexed: 11/17/2022]
Abstract
Plectin mutations have been reported in epidermolysis bullosa simplex with muscular dystrophy. We report the first case of left ventricular non-compaction in an 18-year-old male with epidermolysis bullosa simplex with muscular dystrophy. The patient was diagnosed with epidermolysis bullosa simplex after blistering was noted at birth. Motor function difficulties were first recognized at age 11, however the patient was lost to follow up. He was re-evaluated at age 17 and demonstrated significant ptosis, ophthalmoparesis, and pharyngeal muscle weakness. He had predominant proximal muscle weakness with the inability to raise arms against gravity. He was ambulatory for short distances but lost the ability to rise from the floor at 14 years. He was subsequently diagnosed with epidermyolysis bullosa simplex with muscular dystrophy and a PLEC1 mutation. Screening cardiovascular imaging revealed a diagnosis of isolated left ventricular non-compaction. This case highlights the potential for delayed onset muscular dystrophy in patients with epidermolysis bullosa simplex. Furthermore, this case also underscores the importance of long term, routine cardiac evaluation, including imaging and electrophysiologic evaluation, in patients with epidermolysis bullosa simplex with muscular dystrophy as the cardiac phenotype appears to parallel the variable severity and age of onset that characterize the neuromuscular phenotype.
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Affiliation(s)
- Chet R Villa
- Cincinnati Children's Hospital Medical Center Heart Institute, Cincinnati, OH, USA.
| | - Thomas D Ryan
- Cincinnati Children's Hospital Medical Center Heart Institute, Cincinnati, OH, USA
| | - James J Collins
- Cincinnati Children's Hospital Medical Center Division of Neurology, Cincinnati, OH, USA
| | - Michael D Taylor
- Cincinnati Children's Hospital Medical Center Heart Institute, Cincinnati, OH, USA
| | - Anne W Lucky
- Cincinnati Children's Hospital Medical Center Division of Dermatology, Cincinnati, OH, USA
| | - John L Jefferies
- Cincinnati Children's Hospital Medical Center Heart Institute, Cincinnati, OH, USA
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Chong YK, Ma LCK, Lo KL, Lee CKL, Mak CM, Kan ANC, Lam CW. Dystroglycanopathy with two novel POMT1 mutations in a Chinese boy with developmental delay and muscular dystrophy. Eur J Paediatr Neurol 2014; 18:532-5. [PMID: 24657014 DOI: 10.1016/j.ejpn.2014.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 01/28/2014] [Accepted: 03/01/2014] [Indexed: 11/19/2022]
Abstract
Alpha-dystroglycanopathies are a group of diseases due to reduced glycosylation of alpha-dystroglycan, which commonly result from mutations in POMT1, POMT2, and POMGnT1. Patients with alpha-dystroglycanopathies present with muscular, cerebral, and ocular involvements with differing severities. We reported a boy who presented with muscular dystrophy, developmental delay, and non-specific white matter lesions. Mutation analysis of POMT1 was performed and revealed two novel mutations, a substitution mutation (c.176T>G) and a duplication mutation (c.2059dupC) which results in premature termination of translation. In-silico prediction in five different platforms concurred that the substitution is damaging, and functional studies by immunofluorescence revealed lack of staining in the carbohydrate moiety of alpha-dystroglycan, confirming the molecular findings in a functional manner. In conclusion, we reported the first case of genetically confirmed alpha-dystroglycanopathy due to mutations in POMT1 in Chinese.
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Affiliation(s)
- Yeow Kuan Chong
- Genetic Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong Special Administrative Region
| | - Louis Che Kwan Ma
- Department of Paediatrics, United Christian Hospital, Hong Kong Special Administrative Region
| | - Kit Lin Lo
- Department of Diagnostic Radiology and Organ Imaging, United Christian Hospital, Hong Kong Special Administrative Region
| | - Clary Ka Lai Lee
- Department of Pathology, United Christian Hospital, Hong Kong Special Administrative Region
| | - Chloe Miu Mak
- Genetic Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong Special Administrative Region
| | - Amanda Nim Chi Kan
- Department of Pathology, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Ching Wan Lam
- Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
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Pouwels S, de Boer A, Leufkens HGM, Weber WEJ, Cooper C, van Onzenoort HAW, de Vries F. Risk of fracture in patients with muscular dystrophies. Osteoporos Int 2014; 25:509-18. [PMID: 23948807 DOI: 10.1007/s00198-013-2442-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 06/24/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED The aim of the study was to determine fracture risk in incident muscular dystrophy (MD) patients. Patients with MD are at a 1.4-fold increased risk of fracture as compared with population-based control patients. Risk further increased among elderly and female patients and among patients exposed to oral glucocorticoids. INTRODUCTION Muscular dystrophies (MDs) are inherited diseases causing muscle weakness and thereby increase the risk of falling and detrimental effects on bone. Both are recognised risk factors for fracture. Therefore, the aim of this study was to determine the hazard ratio of fracture in patients with MD. METHODS We conducted a retrospective cohort study using the UK General Practice Research Database (1987-2012). Each patient with MD was matched by year of birth, sex and practice to up to six patients without a history of MD. Outcome measure was all fractures. RESULTS As compared with control patients, risk of any fracture was statistically significantly increased in MD patients (adjusted hazard ratio [AHR], 1.40; 95 % confidence interval [CI], 1.14-1.71). An increased risk of fracture was observed among MD patients with female gender (AHR, 1.78; 95 % CI, 1.33-2.40) and an increasing age as compared with control patients. Stratification to Duchenne MD showed no association with fracture, whereas risk of fracture was increased twofold among patients with myotonic dystrophy (AHR, 2.34; 95 % CI, 1.56-3.51). MD patients had an almost tripled risk of fracture when they used oral glucocorticoids in the previous 6 months as compared to non-users with MD. CONCLUSION Patients with MD are at a 1.4-fold increased risk of fracture as compared with population-based control patients. Especially in older age groups and female gender, the fracture risk of MD versus non-MD patients is increased, whereas exposure to glucocorticoids further increased fracture risk among MD patients.
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Affiliation(s)
- S Pouwels
- Utrecht Institute for Pharmaceutical Sciences, Universiteit Utrecht, Utrecht, Netherlands
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Abstract
This article describes the preoperative preparation of patients with neuromuscular disorders. These entities are a relatively rare and diverse group of diseases that can affect various organ systems in addition to the central nervous system. The anesthetic implications for the various comorbidities are varied and can be profound. These patients should be optimized before surgery, with the involvement of a multidisciplinary team of specialists.
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Affiliation(s)
- Palak Turakhia
- Anesthesiology, UNC Hospitals, University of North Carolina, N2198, CB# 7010, Chapel Hill, NC 27599-7010, USA.
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Florian A, Ludwig A, Rösch S, Sechtem U, Yilmaz A. Magnetic resonance of the heart in a muscular dystrophy patient with an MR conditional ICD: assessment of safety, diagnostic value and technical limitations. J Cardiovasc Magn Reson 2013; 15:49. [PMID: 23758805 PMCID: PMC3688460 DOI: 10.1186/1532-429x-15-49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 06/04/2013] [Indexed: 11/10/2022] Open
Abstract
Cardiovascular magnetic resonance (CMR) studies in patients with pacemakers or implantable cardioverter/defibrillators (ICD) are increasingly required in daily clinical practice. Therefore, in the last years the manufacturers developed not only MR-conditional pacemakers, but also MR-conditional ICDs. However, the clinical experience regarding the feasibility and limitations of MR studies of the heart in patients with ICDs is still limited. In particular, there are hardly any CMR studies in the same patients performed prior to and post ICD implantation allowing a one-to-one comparison of the obtained CMR images. This is the first presentation of a CMR study in a patient with the world's first and so far only MR-conditional ICD. In our case, a major problem related to the presence of the MR conditional ICD was an image artifact caused by the device's generator which hampered the visualization of the midventricular and apical anterior and antero-lateral segments in all sequences performed. Considering previous studies, right chest implantation of the ICD could probably have helped in this setting and may be preferred in future ICD implantations. Our case report nicely illustrates the real clinical need for specially designed implantable devices that ensure safe and high-quality imaging in patients in whom serial CMR is required.
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Affiliation(s)
- Anca Florian
- From the Department of Cardiology and Angiology, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany
| | - Anna Ludwig
- From the Division of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Sabine Rösch
- From the Division of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Udo Sechtem
- From the Division of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Ali Yilmaz
- From the Department of Cardiology and Angiology, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany
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Abstract
Limb contractures are a common impairment in neuromuscular diseases. They contribute to increased disability from decreased motor performance, mobility limitations, reduced functional range of motion, loss of function for activities of daily living, and increased pain. The pathogenesis of contractures is multifactorial. Myopathic conditions are associated with more severe limb contractures compared with neuropathic disorders. Although the evidence supporting the efficacy of multiple interventions to improve range of motion in neuromuscular diseases in a sustained manner is lacking, there are generally accepted principles with regard to splinting, bracing, stretching, and surgery that help minimize the impact or disability from contractures.
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Affiliation(s)
- Andrew J Skalsky
- Rady Children's Hospital, Division of Pediatric Rehabilitation, MC 5096, 3020 Children's Way, University of California San Diego School of Medicine, San Diego, CA 92123, USA
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Murakami N, Hayashi YK, Oto Y, Shiraishi M, Itabashi H, Kudo K, Nishino I, Nonaka I, Nagai T. Congenital generalized lipodystrophy type 4 with muscular dystrophy: clinical and pathological manifestations in early childhood. Neuromuscul Disord 2013; 23:441-4. [PMID: 23489663 DOI: 10.1016/j.nmd.2013.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 12/28/2012] [Accepted: 02/06/2013] [Indexed: 11/19/2022]
Abstract
A boy with congenital generalized lipodystrophy type 4 with muscular dystrophy presented in infancy with delay in motor milestones and a persistent elevation of CK. There was no associated mental retardation. He was followed up to 3 years and 11 months; he had a homozygous c.696_697insC mutation in polymerase I and transcript release factor (PTRF). He started to walk at 2 years and 6 months although he did not have mental retardation. Insulin resistance appeared at 3 years and 11 months of age. PTRF immunostaining positivity was absent in the muscle but caveolin-3 was preserved in the sarcolemma at 16 months of age. Secondary deficiency of caveolins may be closely associated with disease progression.
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Affiliation(s)
- Nobuyuki Murakami
- Department of Pediatrics, Dokkyo Medical University, Koshigaya Hospital, Koshigaya, Saitama, Japan.
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Lai JS, Nowinski C, Victorson D, Bode R, Podrabsky T, McKinney N, Straube D, Holmes GL, McDonald CM, Henricson E, Abresch RT, Moy CS, Cella D. Quality-of-life measures in children with neurological conditions: pediatric Neuro-QOL. Neurorehabil Neural Repair 2012; 26:36-47. [PMID: 21788436 PMCID: PMC3710728 DOI: 10.1177/1545968311412054] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A comprehensive, reliable, and valid measurement system is needed to monitor changes in children with neurological conditions who experience lifelong functional limitations. OBJECTIVE This article describes the development and psychometric properties of the pediatric version of the Quality of Life in Neurological Disorders (Neuro-QOL) measurement system. METHODS The pediatric Neuro-QOL consists of generic and targeted measures. Literature review, focus groups, individual interviews, cognitive interviews of children and consensus meetings were used to identify and finalize relevant domains and item content. Testing was conducted on 1018 children aged 10 to 17 years drawn from the US general population for generic measures and 171 similarly aged children with muscular dystrophy or epilepsy for targeted measures. Dimensionality was evaluated using factor analytic methods. For unidimensional domains, item parameters were estimated using item response theory models. Measures with acceptable fit indices were calibrated as item banks; those without acceptable fit indices were treated as summary scales. RESULTS Ten measures were developed: 8 generic or targeted banks (anxiety, depression, anger, interaction with peers, fatigue, pain, applied cognition, and stigma) and 2 generic scales (upper and lower extremity function). The banks reliably (r > 0.90) measured 63.2% to 100% of the children tested. CONCLUSIONS The pediatric Neuro-QOL is a comprehensive measurement system with acceptable psychometric properties that could be used in computerized adaptive testing. The next step is to validate these measures in various clinical populations.
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Affiliation(s)
- Jin-Shei Lai
- Department of Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL 60611, USA.
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Kuru S. [Respiratory management in muscular dystrophies]. Brain Nerve 2011; 63:1229-36. [PMID: 22068475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Respiratory failure is a major contributor to immobility and mortality in progressive muscular dystrophies. The severity of pulmonary impairment and the stage at which it develops differ according to the type of muscular dystrophy. Appropriate respiratory management for each type should be considered. In Duchenne muscular dystrophy (DMD), respiratory impairment manifests in the late teens, and assisted mechanical ventilation is administered. Noninvasive positive-pressure ventilation (NIPPV) has increased the median survival of patients with DMD by 10 year and improved quality of life. In myotonic dystrophy (MyD), the causes of respiratory failure can involve both the central and the peripheral nervous systems in addition to respiratory muscles. Nocturnal desaturation is more severe in MyD than in other muscular dystrophies with similar degrees of respiratory muscle weakness. Cognitive impairment should be taken into account in the management of MyD patients. NIPPV does not appear to improve survival of MyD. Guidelines for DMD have been published. Respiratory function should be assessed serially by measuring forced vital capacity, oxyhemoglobin saturation, peak cough flow, and end-tidal CO2 level. A respiratory action plan should be enacted with increasing disease severity. Therapeutic measures comprise airway clearance, respiratory muscle training, noninvasive nocturnal ventilation, daytime noninvasive ventilation, and continuous invasive ventilation. At the advanced stage of respiratory failure, attention should be paid to complications related to long-term mechanical ventilation, such as pneumothorax and tracheal hemorrhage. Discussing about end-of-life care among the patient, family, and physician is important before mechanical ventilatory support is required.
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Affiliation(s)
- Satoshi Kuru
- Department of Neurology, Suzuka National Hospital, Suzuka-shi, Mie, Japan
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Yamada M, Kimura T. [Successful use of sugammadex in a muscular dystrophy patient]. Masui 2011; 60:1205-1206. [PMID: 22111367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Muscular dystrophy requires cautious administration of muscle relaxants due to variable sensitivity and prolonged effects. A 43-year-old man with muscular dystrophy was scheduled for open reduction and internal fixation under general anesthesia. Following patient's TOF ratio with the muscle relaxation monitor, 80 minutes after rocuronium bromide (Rb) administration, we found that TOF ratio was over 0.9. We used sugammadex 4 mg x kg(-1) to reverse Rb-induced neuromuscular block, and then extubated. There was no clinical adverse effect on his muscular function and no respiratory distress after the use of sugammadex in the postoperative phase. Reversal of Rb-induced neuromuscular block by sugammadex in a patient with muscular dystrophy is efficient and safe.
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Affiliation(s)
- Miki Yamada
- Department of Anesthesia, Yokohama Shin-Midori General Hospital, Yokohama 226-0025
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41
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Yamauchi H, Sobue K. [Anesthesia preoperative preparation of muscular dystrophy]. Masui 2010; 59:1093-1095. [PMID: 20857662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The muscular dystrophies are inherited myogenic disorders characterized by progressive muscle wasting and weakness of variable distribution and severity. They can be subdivided into several groups, including congenital forms, in accordance with the distribution of predominant muscle weakness: Duchenne/Becker; limb-girdle; Fukuyama type congenital muscular dystrophy; Emery-Dreifus; facioscapulohumeral; oculopharyngeal; myotonic dystrophy, et al. Muscular dystrophies are susceptible to perioperative respiratory, cardiac and other complications, such as rhabdomyolysis. Halogenated inhalational anesthetic agents have been implicated as a cause of acute rhabdomyolysis that resembles malignant hyperthermia. Depolarizing neuromuscular blocking drugs that cause rhabdomyolysis are contraindicated in these patients. Recommendations are proposed for the safe anesthetic management of these patients.
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Affiliation(s)
- Hiroki Yamauchi
- Toyota-Kai Medical Corporation, Kariya Toyota General Hospital, Kariya 448-8505
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Fuschillo S, Torrente Y, Balzano G. Severe respiratory and skeletal muscles involvement in a carrier of dysferlinopathy with chronic obstructive pulmonary disease. Respir Care 2010; 55:1091-1093. [PMID: 20667157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The natural course of progressive neuromuscular diseases can be complicated by respiratory muscle involvement. In muscular dystrophies such as Duchenne muscular dystrophy and myotonic dystrophy, respiratory muscle involvement is common. In others such as Becker, limb-girdle, and facioscapulo-humeral dystrophies, respiratory muscle involvement is infrequent and generally occurs in the more severe cases. Recently, it was reported that a mutation in the dysferlin gene and/or dysferlin deficiency causes proximal and distal forms of muscular dystrophy, which are known by the term dysferlinopathy. We describe a case of severe weakness of both limb-girdle and respiratory muscles in a patient who was carrier of the dysferlin gene mutation and who also had COPD. We suggest that the systemic inflammatory response of COPD and the dysferlin deficit interact and are responsible for both the skeletal and respiratory muscle impairment.
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Affiliation(s)
- Salvatore Fuschillo
- Division of Pneumology, Scientific Institute of Telese Terme, Salvatore Maugeri Foundation, Telese Terme (BN), 82037 Italy.
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Chanchlani N. Muscular dystrophy patients could live extra 15 years, if care standards implemented. BMJ 2010; 340:c3055. [PMID: 20530562 DOI: 10.1136/bmj.c3055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Cardiac abnormalities occur in association with many of the neuromuscular disorders that present in childhood. Genetic defects involving the cytoskeleton, nuclear membrane, and mitochondrial function have all been described in patients with skeletal myopathy and cardiac involvement. The most common classes of neuromuscular disorders with cardiac manifestations are the muscular dystrophies- Duchenne, Becker, limb-girdle and Emery Dreifuss. Friedreich Ataxia and myotonic dystrophy also have important cardiac involvement. The type and extent of cardiac manifestations are specific to the type of neuromuscular disorder. The most common cardiac findings include dilated or hypertrophic cardiomyopathy, atrioventricular conduction defects, atrial fibrillation and ventricular arrhythmias. Screening for cardiac involvement should be performed in all children with neuromuscular disorders that have the potential for cardiac involvement. This review discusses the cardiac findings associated with specific neuromuscular disorders and outlines the indications for evaluation and treatment.
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Affiliation(s)
- Daphne T Hsu
- Children's Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, New York 10467, USA.
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Vandenberghe W, Jacobs TF, Plasschaert FS, Willems J, Den Blauwen NM, Vereecke HE, Wouters P. Anesthesia and perioperative management for a patient with Ullrich syndrome undergoing surgery for scoliosis. Acta Anaesthesiol Belg 2010; 61:43-47. [PMID: 20593644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Ullrich syndrome is a rare congenital hypotonic-sclerotic muscular disorder in which affected children develop a slowly progressive scoliosis and contractures and limpness of joints. The disease causes increasingly invalidating contractures and hardening of the muscles of the neck and trunk. While this neuromuscular type of scoliosis is progressive, patients rarely attain the point of surgery due to their compromised general medical condition. This may explain the current lack of outcome data and the paucity of information on perioperative management for patients with Ullrich syndrome undergoing major surgery. The purpose of this report was therefore to describe our first experience with the perioperative and anesthetic management of a 15-year-old boy presenting with Ullrich syndrome and a secondary invalidating scoliosis. The specific challenges of this condition characterized by severe restrictive lung disease and a challenging airway abnormality are discussed.
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Affiliation(s)
- W Vandenberghe
- Department of Anesthesiology, Ghent University Hospital, Ghent, Belgium
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Düger T, Yilmaz O, Aki E, Kayihan H, Karaduman A. The environmental barriers of children with Muscular Dystrophies and its effect on mother's low back pain. Disabil Rehabil 2009; 25:1187-92. [PMID: 14534062 DOI: 10.1080/09638280310001599952] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study is to determine the architectural barriers of children with Muscular Dystrophy at home according to their diminished functional capacity and its effect on their mother's back problem. METHOD Twenty children with Muscular Dystrophy (11.1 +/- 4.14 years) were evaluated with Brooke Scale and WeeFIM. Quebec and Oswestry Disability Scales were used for determining physical disability of their mothers (38.65 +/- 5.91 years). The architectural barriers have been detected with attention to standard criterias of International Organizations for all countries around the world. RESULTS The heights of thresholds, switches of wall plugs, shelves, cupboards, mirrors, hangers, arm of windows and siphons were found to be higher than standard values. The relation between back disability questionnaire results of mothers and dependency level of children on Activity of Daily Living has showed negative correlation (p < 0.05). CONCLUSIONS The protective back health programmes and home arrangements that are suitable for disabled children must be added to the neuromuscular rehabilitation programmes.
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Affiliation(s)
- Tülin Düger
- Hacettepe University, School of Physical Therapy and Rehabilitation, Ankara, Turkey
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47
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Puangsuvan N, Mester RA, Ramachandran V, Tobias JD. Perioperative care of a child with Ullrich congenital muscular dystrophy. Middle East J Anaesthesiol 2009; 20:319-323. [PMID: 19583090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Ullrich congential muscular dystrophy (UCMD) is a severe form of congenital muscular dystrophy manifesting axial muscle contractures and distal joint hyperlaxity. Severe hypotonia and associated respiratory failure may occur early in the disease process. Given the various associated orthopedic conditions, anesthetic management may be required during surgical interventions to correct skeletal deformities or these patients may present with surgical conditions unrelated to their primary illness. We present a 4-year-old with UCMD who required operative intervention for a ruptured appendix. Anesthetic care implications included the need for a rapid airway control to limit the risks of aspiration due to the intra-abdominal process, choice of neuromuscular blocking agent for rapid sequence intubation, associated airway issues related to micrognathia and limited mouth opening, and the potential for involvement of the cardiovascular and respiratory systems. The perioperative management of patients with UCMD is discussed including the use of propofol and remifentanil for rapid sequence intubation to avoid the need for neuromuscular blocking agents.
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Politano L, Palladino A, Nigro G, Scutifero M, Cozza V. Usefulness of heart rate variability as a predictor of sudden cardiac death in muscular dystrophies. Acta Myol 2008; 27:114-122. [PMID: 19472920 PMCID: PMC2858940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Sudden cardiac death, or cardiac arrest, is a major health problem, causing about 166,200 deaths each year among adults in the United States. It may be caused by almost all known heart diseases. Most cardiac arrests occur when the diseased heart begins to exhibit rapid and/or chaotic activity, such as ventricular tachycardia or fibrillation. Some are due to extreme slowing of the heart. All these events are called life-threatening arrhythmias. Arrhythmogenic cardiomyopathy is a frequent feature in several muscular dystrophies with a potential risk of cardiac sudden death. Among the measures able to predict the propensity to develop life-threatening arrhythmias, heart rate variability is an accepted non invasive measurement of cardiac autonomic modulation. The use of heart rate variability to measure the extent of changes in autonomic nervous system is an established risk stratification procedure in different diseases. In fact numerous studies have demonstrated the positive prognostic power of altered heart rate variability values to predict all-cause mortality, cardiac events, sudden cardiac death and heart transplantation. Usefulness of heart rate variability as a predictor of sudden cardiac death in muscular dystrophies has been reviewed.
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Affiliation(s)
- L Politano
- Department of Experimental Medicine, Cardiomyology and Medical Genetics, Second University of Naples, Naples, Italy
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Motono N, Aoki T, Shimada K, Nakayama T, Yazawa M. [Successful perioperative management with non-invasive positive pressure ventilation in muscular dystrophy with thymoma; report of a case]. Kyobu Geka 2008; 61:907-909. [PMID: 18788386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We report a case of muscular dystrophy with thymoma that was detected by chance at the examination of his fatal arrhythmia. He has hypercapnea and restrictive pulmonary disfunction, but non-invasive positive pressure ventilation (NPPV) had not been introduced. Thymo-thymectomy was performed through reversed L-shaped mediansternotomy. NPPV was effective in his perioperative management.
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Affiliation(s)
- N Motono
- Department of Pulmonary Surgery, Niigata Prefectural Central Hospital, Joetsu, Japan
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Chang XZ, Chen SH, Zhang YH. [Congenital muscular dystrophy complicated with tetanized spinal column in a case]. Zhonghua Er Ke Za Zhi 2008; 46:477-478. [PMID: 19099795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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