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1A型缺乏层黏连蛋白α2的先天性肌营养不良症

Merosin-deficient congenital muscular dystrophy type 1A.

作者信息

Buteică Elena, Roşulescu Eugenia, Burada F, Stănoiu B, Zăvăleanu Mihaela

机构信息

Department of Genetics, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Rom J Morphol Embryol. 2008;49(2):229-33.

Abstract

Merosin-deficient congenital muscular dystrophy type 1A (MDC1A) is the most common form of congenital muscular dystrophy. MDC1A is caused by mutation of the laminin alpha-2 gene (LAMA2), localized to chromosome 6q22-23. The diagnosis of merosin-deficient CMD is based on the clinical findings of severe congenital hypotonia, weakness, with high blood levels of creatine kinase, WM abnormalities, and dystrophy associated with negative immunostaining of biopsied muscle for merosin. We investigated clinical and laboratory a patient: a girl with merosin-deficient congenital muscular dystrophy type 1A. Clinically the particularity of the case is the association of merosin-negative congenital muscular dystrophy (MN-CMD) with congenital feet deformity. The level of serum creatine kinase is elevated 1045 U/L. Immunohistochemistry show presence of dystrophin, lack of merosin, also the utrophin is normally expressed. Nerve conduction studies are normally, while electromyography suggested a myopathic process with early recruitment and decreased amplitude and duration of response. Magnetic resonance imaging: MRI T1 and MRI T2 show hypointensity and diffuse hyperintensity respectively in the white matter. Supratentorial MRI images showed hypotrophy of the corpus callosum and almost absent cingulate gyrus. In addition, hypophysis is reduced size.

摘要

1A 型缺乏层黏连蛋白的先天性肌营养不良(MDC1A)是先天性肌营养不良最常见的形式。MDC1A 由定位于 6q22 - 23 染色体的层黏连蛋白α-2 基因(LAMA2)突变引起。缺乏层黏连蛋白的先天性肌营养不良的诊断基于严重先天性肌张力减退、肌无力的临床表现,以及肌酸激酶血水平升高、白质异常,和活检肌肉中针对层黏连蛋白的免疫染色阴性相关的营养不良。我们对一名患者进行了临床和实验室检查:一名患有 1A 型缺乏层黏连蛋白的先天性肌营养不良的女孩。临床上该病例的特殊性在于缺乏层黏连蛋白的先天性肌营养不良(MN - CMD)与先天性足部畸形相关。血清肌酸激酶水平升高至 1045 U/L。免疫组织化学显示有抗肌萎缩蛋白存在,缺乏层黏连蛋白,并且肌养蛋白正常表达。神经传导研究正常,而肌电图提示为肌病过程,募集早期出现,反应幅度和时限降低。磁共振成像:MRI T1 和 MRI T2 分别显示白质低信号和弥漫性高信号。幕上 MRI 图像显示胼胝体萎缩,扣带回几乎缺如。此外,垂体体积减小。

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