A case of congenital myopathy caused by the SPEG gene mutation / 中华实用儿科临床杂志

Clinical data of a child with congenital myopathy caused by the SPEG gene mutation diagnosed in the Children′s Hospital of Nanjing Medical University in March 2020 were retrospectively analyzed, and the relevant literature was reviewed.A 13-year-old female child with lagged motor development since childhood, weakness of both lower extremities for 10 years, and slow progression of disease.Physical examinations showed gait swinging, mild hypertrophy of gastrocnemius, positive Gower sign, grade Ⅴ distal muscle strength of both lower extremities, and grade Ⅳ proximal muscle strength.The electromyography showed myogenic damage changes.Her 11-year-old sister presented similar symptoms of muscle weakness.Gene sequencing revealed compound heterozygous mutations in the SPEG gene, with the newly reported mutation sites at c. 3715+ 4C>T and c. 3588delC, which had not been reported at home and abroad.This study for the first time reported a case of congenital myopathy caused by the SPEG gene mutation in China, which differed from previous cases accompanied cardiomyopathy.This case report expanded the mutation spectrum of the SPEG gene.

Typical congenital nemaline myopathy: ACTA1 pathogenic variant

@#Nemaline myopathy (NM) is a primary muscle disorder presenting with proximal muscles weakness at birth or infancy and gross motor delay. This is a case report of a sixteen year old male who presented with proximal muscle weakness at 5 months of age. His gene testing revealed ACTA1 gene mutation, which is associated with nemaline myopathy. He presented with a relatively benign and slowly progressive course of weakness, not complicated by respiratory or cardiac symptoms.

Diagnóstico y tratamiento de las miopatías congénitas / Diagnosis and treatment of congenital myopaties

Existen importantes avances en el campo de las miopatías congénitas en los últimos años que obligan a la revisión y actualización constante de este grupo de enfermedades. La identificación creciente de nuevos genes y fenotipos asociados a genes ya conocidos, fue posible en gran medida gracias al avance de las técnicas de secuenciación de nueva generación, cada vez más accesibles. El conocer mejor el espectro fenotípico de estas entidades, permite establecer una correlación fenotipo/genotipo en algunos subgrupos. La mejor compresión de la fisiopatología e historia natural de estas enfermedades, son fundamentales para el desarrollo de nuevas terapias. Los primeros ensayos clínicos en el campo de la terapia génica ya son una realidad y están mostrando resultados positivos, creando una nueva expectativa en paciente, familiares y especialistas, lo que se verá reflejado en la necesidad de adaptar los protocolos de atención, diagnóstico y tratamiento de algunas de estas entidades. Es fundamental que los neuropediatras, pediatras, fisioterapeutas y otros profesionales involucrados en el cuidado de estos pacientes, estén informados y actualizados de los avances en este grupo de enfermedades.

Important advances have been made in the field of congenital myopathies in recent years, forcing clinicians to constantly review and update this group of diseases. The increasing identification of new genes and phenotypes associated with already known genes has been possible to a great extent thanks to the development accomplished in next generation sequencing techniques, which are increasingly accessible. Knowing better the phenotypic spectrum of these entities allows to establish a phenotype/genotype correlation in some subgroups. The best understanding of the pathophysiology and natural history of these diseases are fundamental to design new therapies. The first clinical trials in the field of gene therapy are already a reality and are showing positive results, creating a new expectation for patients, families and specialists, which will be reflected in the need to adapt the protocols of care, diagnosis and treatment of some of these entities. It is essential that pediatric neurologists, pediatricians, physiotherapists and other professionals involved in the care of these patients are informed and updated on the advances in this group of diseases.

Progress in the diagnosis and treatment of congenital fiber-type disproportion / 国际儿科学杂志

Congenital fiber-type disproportion (CFTD) is a rare form of congenital myopathy,characterized by non-progressive generalized muscle weakness from early childhood.Diagnosis depends on crucial histological abnormality that type 1 muscle fibers are consistently smaller than type 2 fibers in the absence of other specific histological abnormalities.Whether CFTD should be regarded as a distinct diagnostic entity has always been a controversial issue.Many pathogenic genes have been identified in recent years.This article reviews clinical manifestation,pathology,genetic diagnosis and treatment progress of CFTD.

Diagnosis and therapy of congenital myopathies / 中华实用儿科临床杂志

Congenital myopathies are a group of genetic muscle disorders with a relatively non-progressive clinical course,characterized by weakness and hypotonia of varying severity,morphologically recognized by specific structural abnormalities within the myofibers.The diagnosis of congenital myopathies mainly based on characterized clinical manifestation and histological features on muscle biopsy.The genetic basis of many different forms of the congenital myopathies has been identified,while there are still more genes to be discovered.Until now,the main management of congenital myopathies was to alleviate complications arising from weakness of various muscle groups.

Young Ischemic Stroke Combined with Congenital Myopathy:1 Case Report / 中国康复理论与实践

Objective To explore the characteristics and rehabilitation treatment methods of young ischemic stroke combined with con-genital myopathy. Methods The clinical data of one young patient with ischemic stroke combined with congenital myopathy was retrospec-tive analyzed, and its pathological feature and rehabilitation treatment methods were also analyzed. Results The etiology may be artery dis-section mural thrombus fell off. Conclusion The etiology of young ischemic stroke should be clear diagnosed, and the intensity of rehabilita-tion training need attention.

Young Ischemic Stroke Combined with Congenital Myopathy: 1 Case Report / 中国康复理论与实践

@# Objective To explore the characteristics and rehabilitation treatment methods of young ischemic stroke combined with congenital myopathy. Methods The clinical data of one young patient with ischemic stroke combined with congenital myopathy was retrospective analyzed, and its pathological feature and rehabilitation treatment methods were also analyzed. Results The etiology may be artery dissection mural thrombus fell off. Conclusion The etiology of young ischemic stroke should be clear diagnosed, and the intensity of rehabilitation training need attention.

A Case of Centronuclear Myopathy

Centronuclear myopathy is a rare congenital myopathy, which is characterized by centrally located nuclei and hypotrophy or predominance of type 1 fibers in muscle pathology. It is classified into three forms according to the clinical features and inheritance pattern: the X-linked recessive, the autosomal recessive, and the autosomal dominant forms. We report a case of a patient with generalized muscle weakness, poor muscle bulk, and dysmorphic features who was diagnosed as centronuclear myopathy.

Comparison of Clinical Characteristics Between Congenital Fiber Type Disproportion Myopathy and Congenital Myopathy with Type 1 Fiber Predominance

Congenital myopathies are clinical and genetic heterogeneous disorders characterized by skeletal muscle weakness and specific structural changes in muscle fiber. Congenital myopathy with fiber type disproportion (CFTD) is an established disorder of congenital myopathy. CFTD is characterized by non-progressive childhood neuromuscular disorders with a relatively good prognosis and type 1 fiber predominance and smallness. Congenital myopathy with type 1 fiber predominance (CMT1P) is also a distinct entity of congenital myopathy characterized by non-progressive childhood neuromuscular disorders and type 1 fiber predominance without smallness. Little is known about CMT1P. Clinical characteristics, including dysmorphic features such as hip dislocation, kyphoscoliosis, contracture, and high arch palate, were analyzed along with laboratory and muscle pathologies in six patients with CMT1P and three patients with CFTD. The clinical manifestations of CFTD and CMT1P were similar. However, the frequency of dysmorphic features is less in CMT1P than in CFTD. Long term observational studies of CMT1P are needed to determine if it will change to another form of congenital myopathy or if CMT1P is a distinct clinical entity.

A Case of Congenital Fiber Type Disproportion with Multiple Anomalies / 대한소아신경학회지

Congenital fiber type disproportion (CFTD) is a rare form of congenital myopathy characterized by the smallness and the marked predominance of type 1 fibers, which presents congenital hypotonia, delayed motor milestones, joint contractures, and skeletal deformities. The muscle biopsy reveals the type 1 fibers are more than 12% smaller than the type 2 fibers in size. We describe a 24-month-old boy who presented muscle hypotonia, delayed motor milestones, mental retardation with generalized tonic clonic seizures, and the muscle pathologic findings of CFTD. Additional findings included left cryptorchidism, congenital subluxation of the hip, contractures of ankle joints, diffuse brain atrophy, and optic nerve atrophy. We should consider CFTD as a differential diagnosis of early onset myopathy.

A Case of Adult-Onset Centronuclear Myopathy

Centronuclear myopathy (CNM) is a rare congenital myopathy that is characterized by centrally placed nuclei in the muscle fibers. Based on the time of onset and the mode of inheritance, CNM can be divided into three distinct forms: the severe neonatal form, the childhood onset form, and the adult onset form. This paper describes the case of a female patient with CNM, in whom the disease manifested itself in the fifth decade of life, without any prior family history of such disorders. To the best of our knowledge, this is a rare case of late adult-onset CNM.

A Case of Congenital Neuromuscular Disease with Uniform Type 1 Fiber

Congenital neuromuscular disease with uniform type 1 fiber (CNMDU1) is a rare but distinct form of nonprogressive, congenital myopathy. CMNDU1 is characterized by a type 1 muscle fiber content of more than 99%. This condition has only been previously described in a few reports. The authors report an 11-year-old girl who exhibited delayed developmental milestones, proximal muscle weakness, and bilateral ptosis. Her serum creatine kinase level was normal but an electromyographic study showed myopathic changes. A biopsy specimen from the left deltoid muscle revealed a uniformity of type 1 fibers (greater than 99%) with a moderate variation in fiber size. This is the first case of CNMDU1 reported in Korea.

A Case of Centronuclear Myopathy

Centrinuclear myopathy, an uncommon condition, is one of the congenital myopathies. It is characterized by the presence of central nuclei of muscle cells which can be detected on electronmicroscopy. It is believed to arise as a result of maturational arrest with persistence of microtubes postnatally. We report a boy with generalized hypotonia and muscle weakness who was diagnosed as centrinuclear myopathy by muscle biopsy.

A Case of Minicore Myopathy / 대한소아신경학회지

Minicore myopathy, an uncommon condition, is one of congenital myopathies. It is characterized by multifocal areas of degeneration in muscle fibers. The minicores consist of numerous small areas of decreased oxidative enzyme activity. The axis of the lesion is perpendicular or parallel to the long axis of the muscle fiber. The phenotype has been described as predominantly proximal, static or only slowly progressive muscle weakness. We report a 4 year-old-girl with respiratory failure, thoracic scoliosis, hypotonia and facial weakness, who was diagnosed as minicore myopathy by muscle biopsy. The laboratory investigations, such as creatine phosphokinase and lactic dehydrogenase levels, and the nerve conduction velocity were normal. The muscle biopsy showed marked size variations of myofibers, marked endomyseal and perimyseal fibrosis, and moderate fatty changes in myofibers. The histochemical studies showed multiple focal losses of mitochondria. These findings are consistent with minicore type congenital myopathy.

Muscle fiber type disproportion with an autosomal dominant inheritance

Congenital muscle fiber type disproportion (CFTD) has been described as a form of congenital myopathy characterized by the smallness and marked predominance of type 1 fibers in a muscle biopsy. Clinical manifestations include hypotonia, nonprogressive muscle weakness, joint contractures, and skeletal deformities. However, it has also been noted that the same pathologic alterations appeared in clinically diverse conditions. Recently, we experienced a family, a mother and two children, in which a muscle biopsy showed the mother to have muscle fiber type disproportion. This case was unusual in that there was a significant progression of weakness, an absence of neonatal hypotonia, and other commonly associated musculo-skeletal deformities. In this report, we describe the clinicopathologic features of the family with a brief review about muscle fiber type disproportion.

Congenital Fiber Type Disproportion Myopathy: A case report

Authors report a typical case of congenital fiber type disproportion (CFTD) with unique clinicopathologic characteristics. The patient was a 13-year-old boy who presented with weakness of lower extremities, especially proximal muscle, since his infancy. He has suffered from severe scoliosis which got worse since the age of 12. He showed mild dysarthria, high arched palate, and fish face. All routine laboratory data were within normal limits. EMG findings suggested myopathy. The muscle biopsy revealed fiber type disproportion with type 1 predominance. While most of the type 1 myofibers were atrophic or normal in size, the type 2 fibers showed universal hypertrophy. The difference of mean diameter between the larger and the smaller fibers was 27.9%. The patient's clinicopathologic settings fulfilled the criteria of CFTD.

Histopathologic study on muscle diseases among Koreans (274 muscle biopsy analysis)

All the diagnostic muscle biopsy cases were collected from the file of Department of Pathology, Seoul National University Hospital during June 1976 to December 1978. Slides were reviewed and correlated with clinical informations. Two hundred seventy four cases showed pathological changes, which were classified into six large groups (Table 1). Neurogenic atrophy was most common, 97 cases (35%), including 71 cases of motor neuron disease and 22 cases of peripheral neuropathy. Muscular dystrophy was seen in 92 cases (34%), and Duchenne type was the commonest among them (51 cases). Fifty seven cases showed inflammatory myopathy, making 20% of all cases. There were four cases of congenital myopathy and 13 cases showed various muscle diseases.

Myotubular myopathy: A case report

A case of a myotubular myopathy in a 5 year old boy is described. This was the first and the only boy to a 30 year old mother who had no prenatal or perinatal problems. No family history of muscle disease was present. His muscle weakness started from neonatal period but was very slowly progressive. The developmental milestones were generally delayed. He had repeated episodes of pneumonia. Muscle biopsy revealed characteristic cental nuclei in 68% of myofibers, and this findings was associated with generally small and round fibers and minimal interstitial change. No inflammatory reaction was present.