Clinical Neuroscience Division, King's College, London, UK.
Neuromuscul Disord. 2010 Jan;20(1):49-52. doi: 10.1016/j.nmd.2009.10.005. Epub 2009 Nov 22.
Dynamin 2 (DNM2)-related dominant centronuclear myopathy is usually a mild disorder, but more severe variants have been associated with mutations affecting the pleckstrin homology (PH) domain of the protein, mainly implicated in different forms of Charcot-Marie-Tooth Disease (CMT). Whilst DNM2-related CMT may feature non-neurological findings including cataracts, this has not been reported in DNM2-related centronuclear myopathy. We report a girl presenting from birth with hypotonia, respiratory and feeding difficulties. Motor development was delayed and at 9years she lost the ability to walk. She had ptosis, external ophthalmoplegia and bilateral cataracts. Muscle biopsy showed increase in central nuclei with type 1 hypotrophy and fibrosis. DNM2 screening revealed a novel heterozygous substitution (c.1862T>C; p.Leu621Pro) affecting the PH domain of the protein. Her further course was progressive and at 14years she died from respiratory failure. Our findings expand the phenotypical spectrum associated with DNM2 mutations and provide a new clinical indicator for involvement of this gene in patients with centronuclear myopathy.
动力蛋白 2(DNM2)相关的显性中心核肌病通常是一种轻度疾病,但更严重的变异与影响蛋白的pleckstrin 同源(PH)结构域的突变有关,主要与不同形式的腓骨肌萎缩症(CMT)有关。虽然 DNM2 相关的 CMT 可能具有非神经学表现,包括白内障,但在 DNM2 相关的中心核肌病中尚未报道。我们报告了一名女孩,从出生起就表现出肌张力低下、呼吸和喂养困难。运动发育延迟,9 岁时她失去了行走能力。她有眼睑下垂、眼外肌麻痹和双侧白内障。肌肉活检显示中央核增加,1 型萎缩和纤维化。DNM2 筛查显示一种新的杂合替代(c.1862T>C;p.Leu621Pro),影响蛋白的 PH 结构域。她的病情进一步恶化,14 岁时因呼吸衰竭死亡。我们的发现扩展了与 DNM2 突变相关的表型谱,并为该基因参与中心核肌病患者提供了新的临床指标。