A novel autosomal dominant distal myopathy with early respiratory failure: Clinico-pathologic characteristics and exclusion of linkage to candidate genetic loci

被引:18
作者
Chinnery, PF
Johnson, MA
Walls, TJ
Gibson, GJ
Fawcett, PRW
Jamieson, S
Fulthorpe, JJ
Cullen, M
Hudgson, P
Bushby, KMD
机构
[1] Newcastle Univ, Sch Med, Dept Neurol, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England
[2] Newcastle Univ, Dept Human Genet, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England
[3] Newcastle Univ, Dept Resp Med, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England
[4] Newcastle Univ, Dept Clin Neurophysiol, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England
[5] Newcastle Univ, Dept Neurobiol, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England
关键词
D O I
10.1002/ana.93.abs
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We describe a novel autosomal dominant myopathy presenting in mid-adult life with tibialis anterior weakness. We carried out a detailed clinical assessment of 24 individuals spanning three generations, documenting pathologic features of the muscles in 7 of the 11 affected individuals, including an autopsy study on one case. The second generation of affected individuals presented at an earlier age, and the disease progressed more rapidly than in the first generation. Lung function tests revealed progressive global respiratory muscle weakness detectable from the time of presentation, with preferential diaphragmatic involvement in some cases. Hip girdle and shoulder girdle weakness appeared later in the disease course. We observed a striking correlation between the clinical and pathological features. Clinically unaffected muscles had minimal pathologic change. Fiber splitting, eosinophilic inclusions, and vacuoles with basophilic rims were seen in moderately affected muscles, and fat and fibrous connective tissue replaced muscle fibers in the severely involved muscles. The inclusions were Congophilic and reacted with antibodies to desmin, P-amyloid, and phosphorylated tau protein. The disease was not linked to any of the known loci associated with distal myopathies, confirming that the disorder in this family is both genetically and phenotypically distinct.
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页码:443 / 452
页数:10
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