Center of Medical Genetics, Department of Neonatology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India.
Indian J Pediatr. 2010 Apr;77(4):431-3. doi: 10.1007/s12098-010-0057-6. Epub 2010 Mar 31.
Congenital myopathies are a group of genetic disorders characterized by generalised muscle hypotonia and weakness of varying severity. They are distinct entities and do not include muscular dystrophies, metabolic myopathies and mitochondrial disorders. Myotubular myopathy is a rare sub type within this group of disorders. Clinical differentiation of the various types is difficult and requires muscle biopsy with histopathological and immunohistochemical studies for specific diagnosis. Gene studies are a prerequisite for genetic counseling adn prenatal diagnosis. Here presented three cases of X-linked myotubular myopathy in three Indian families where the diagnosis was established by mutation analysis in the MTM1 gene in all, and supported his histopathology in two. All three families had history of previous male neonatal deaths with similar complaints. Molecular analysis revealed hemizygous mutations in the MTM1 gene including c.1261-10A>G in case, 1, c.70C>T (R24X) in case 2, and a previously unreported mutation, c.924_926delCTT(p. F308del), in case 3. Genetic counseling was performed regarding the X-linked inheritance, their 50% risk of recurrence in boys in subsequent pregnancies, and a feasibility of prenatal diagnosis. This is the first report of cases of X-linked myotubular myopathy from India.
先天性肌病是一组以全身肌肉张力减退和不同程度肌无力为特征的遗传疾病。它们是不同的实体,不包括肌营养不良症、代谢性肌病和线粒体疾病。肌小管肌病是该组疾病中的一种罕见亚型。各种类型的临床鉴别困难,需要进行肌肉活检,进行组织病理学和免疫组织化学研究以进行明确诊断。基因研究是遗传咨询和产前诊断的前提。本研究报告了三例 X 连锁肌小管肌病,分别来自三个印度家庭,所有患者均通过 MTM1 基因突变分析确诊,其中两例还支持其组织病理学结果。这三个家庭都有以前男性新生儿死亡的病史,且具有相似的临床表现。分子分析显示 MTM1 基因的半合突变,包括病例 1 的 c.1261-10A>G,病例 2 的 c.70C>T(R24X),以及病例 3 中一个以前未报道的突变 c.924_926delCTT(p.F308del)。对 X 连锁遗传、男孩在随后妊娠中的 50%复发风险以及产前诊断的可行性进行了遗传咨询。这是印度首例 X 连锁肌小管肌病病例报告。