Ujike H, Tomita J, Kuroda S, Otsuki S, Arahata K
Department of Neuropsychiatry, Okayama University Medical School, Japan.
No To Shinkei. 1991 Oct;43(10):975-9.
Different diagnosis of Becker muscular dystrophy (MD) from limb-girdle MD mainly depends on the differences of heredity form and age at onset. However, sporadic cases with either type of MD often occur, and occasionally Becker MD can occur in adult age when limb-girdle MD commonly occurs. We reported the male sporadic case of Becker MD with the onset at 30 year old who was diagnosed by dystrophin staining. At the age of 30, he noticed mild difficulty to stand up and instability when hurrying up stairs. His weakness of lower limb-girdle gradually progressed, but he is able to walk without any support at the present age of 54, and he never showed weakness in upper limbs. Neurological and laboratory examination revealed that severe atrophy of lower limb-girdle, mild calf hypertrophy and moderate elevate of serum CK level. These history and symptoms hardly distinguish between Becker and limb-girdle MD. Immunostaining of biopsy muscle from the patient using the antiserum against synthetic peptide fragment of dystrophin revealed faint and patchy pattern, and immunoblot revealed 380 kd of abnormal size dystrophin. These dystrophin testing confirmed that this case was a rare case of Becker MD with adult-onset and mild clinical course.
贝克型肌营养不良症(MD)与肢带型MD的鉴别诊断主要取决于遗传形式和发病年龄的差异。然而,两种类型的MD都经常出现散发病例,偶尔贝克型MD也会在肢带型MD常见的成年期发病。我们报告了一例30岁起病的男性散发性贝克型MD病例,通过肌营养不良蛋白染色确诊。30岁时,他注意到起身时有轻度困难,快速上楼梯时不稳定。他下肢带肌无力逐渐进展,但在54岁时仍能独立行走,且上肢从未出现过无力。神经学和实验室检查显示下肢带严重萎缩、小腿轻度肥大以及血清肌酸激酶水平中度升高。这些病史和症状很难区分贝克型MD和肢带型MD。使用抗肌营养不良蛋白合成肽片段的抗血清对患者活检肌肉进行免疫染色,显示出微弱且斑驳的模式,免疫印迹显示异常大小的380kd肌营养不良蛋白。这些肌营养不良蛋白检测证实该病例是一例罕见的成年起病且临床过程较轻的贝克型MD。