Bruno C, Bertini E, Santorelli F M, DiMauro S
Department of Neurology, Columbia University, New York, NY, USA.
J Child Neurol. 2000 Feb;15(2):137-8. doi: 10.1177/088307380001500216.
An asymptomatic 13-year-old boy, who never complained of exercise intolerance or myalgia, was found to have markedly elevated serum creatine kinase (CK) levels during a routine check-up. General physical and neurologic examinations were normal. Surprisingly, histochemical and biochemical analysis of muscle showed myophosphorylase deficiency and genetic analysis showed that the patient was homozygous for the most common mutation encountered in McArdle's disease (R49X). This case illustrates the fuzzy correlation between molecular defect and clinical phenotype in patients with McArdle's disease, and suggests that a thorough study of the muscle biopsy is important in patients with idiopathic hyperCKemia for correct diagnosis and careful follow-up.
一名13岁无症状男孩在常规体检中发现血清肌酸激酶(CK)水平显著升高,他从未抱怨过运动不耐受或肌痛。全身体格检查和神经系统检查均正常。令人惊讶的是,肌肉组织化学和生化分析显示肌磷酸化酶缺乏,基因分析表明该患者为麦克尔憩室病(McArdle病)中最常见突变的纯合子(R49X)。该病例说明了麦克尔憩室病患者分子缺陷与临床表型之间的模糊相关性,并表明对于特发性高CK血症患者,彻底的肌肉活检研究对于正确诊断和仔细随访很重要。