Mertz Kirsten D, Jost Bernhard, Glatzel Markus, Min Kan
Institute of Neuropathology, University Hospital Zurich, Switzerland.
Eur Spine J. 2005 Nov;14(9):900-5. doi: 10.1007/s00586-005-0938-y. Epub 2005 May 31.
Central core disease (CCD) is a rare congenital myopathy with autosomal dominant inheritance. Here, we report on two cases of progressive scoliosis in CCD, pointing out the value of a muscle biopsy to establish the correct diagnosis. The first case involves a 13-year-old boy with severe progressive scoliosis and joint contractures. The patient was initially diagnosed with arthropgryposis multiplex congenita. The second case involves a 45-year-old man with severe scoliosis that had slowly progressed over the years. Both patients suffered from unexplained muscle weakness and severe restriction of pulmonary function. The correct diagnoses were established through muscle biopsies taken from the paravertebral musculature during scoliosis surgery. Correction of the spinal deformities was achieved through posterior instrumentation in both patients, with prior anterior release in one patient. Although scoliosis is a common feature in CCD, the correct diagnosis can be missed in scoliosis patients. Therefore, we recommend a muscle biopsy in patients with scoliosis, unexplained muscle weakness and multiple joint problems.
中央核病(CCD)是一种罕见的常染色体显性遗传先天性肌病。在此,我们报告两例CCD患者出现进行性脊柱侧凸的病例,指出肌肉活检对于明确正确诊断的价值。第一例患者为一名13岁男孩,患有严重的进行性脊柱侧凸和关节挛缩。该患者最初被诊断为先天性多发性关节挛缩症。第二例患者为一名45岁男性,患有严重的脊柱侧凸,多年来病情缓慢进展。两名患者均患有不明原因的肌肉无力和严重的肺功能受限。通过在脊柱侧凸手术期间从椎旁肌肉组织进行肌肉活检得以明确正确诊断。两名患者均通过后路器械固定实现了脊柱畸形的矫正,其中一名患者还进行了前路松解。虽然脊柱侧凸是CCD的常见特征,但脊柱侧凸患者可能会漏诊。因此,我们建议对患有脊柱侧凸、不明原因肌肉无力和多关节问题的患者进行肌肉活检。