Bellayou Hanane, Hamzi Khalil, Rafai Mohamed Abdou, Karkouri Mehdi, Slassi Ilham, Azeddoug Houssine, Nadifi Sellama
Genetic and Molecular Pathology Laboratory, Medical School, Hassan II University, 19, rue Tarik-Ibn-Ziad, BP 9154, 10000 Casablanca, Morocco.
J Biomed Biotechnol. 2009;2009:325210. doi: 10.1155/2009/325210. Epub 2009 May 19.
Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are X-linked recessive disorders caused by mutations of the DMD gene located at Xp21. In DMD patients, dystrophin is virtually absent; whereas BMD patients have 10% to 40% of the normal amount. Deletions in the dystrophin gene represent 65% of mutations in DMD/BMD patients. To explain the contribution of immunohistochemical and genetic analysis in the diagnosis of these dystrophies, we present 10 cases of DMD/BMD with particular features. We have analyzed the patients with immunohistochemical staining and PCR multiplex to screen for exons deletions. Determination of the quantity and distribution of dystrophin by immunohistochemical staining can confirm the presence of dystrophinopathy and allows differentiation between DMD and BMD, but dystrophin staining is not always conclusive in BMD. Therefore, only identification involved mutation by genetic analysis can establish a correct diagnosis.
杜兴氏肌营养不良症(DMD)和贝克氏肌营养不良症(BMD)是由位于Xp21的DMD基因突变引起的X连锁隐性疾病。在DMD患者中,肌营养不良蛋白几乎缺失;而BMD患者的肌营养不良蛋白含量为正常量的10%至40%。肌营养不良蛋白基因的缺失占DMD/BMD患者突变的65%。为了解释免疫组织化学和基因分析在这些肌营养不良症诊断中的作用,我们展示了10例具有特殊特征的DMD/BMD病例。我们通过免疫组织化学染色和多重PCR对患者进行分析,以筛查外显子缺失。通过免疫组织化学染色测定肌营养不良蛋白的数量和分布可以确认肌营养不良蛋白病的存在,并有助于区分DMD和BMD,但在BMD中,肌营养不良蛋白染色并不总是具有决定性意义。因此,只有通过基因分析鉴定相关突变才能做出正确诊断。