Centre de Référence des Maladies Neuromusculaires Paris-Est, Institut de Myologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France.
J Neurol. 2011 Jun;258(6):1157-63. doi: 10.1007/s00415-011-5900-9. Epub 2011 Jan 30.
Laing early-onset distal myopathy is a rare autosomal dominant myopathy and caused by mutations in the MYH7 gene, encoding the slow beta myosin heavy chain. We report the first molecularly verified Laing distal myopathy in a French family caused by a novel p.Glu1508del mutation in the MYH7 gene. Interestingly, we identified the identical mutation in an unrelated Norwegian family and, as a de novo mutation, in one sporadic Finnish patient. Described in detail are the clinical and electrophysiological characteristics of 5 patients from the French family. The phenotype in the Finnish patient and the Norwegian patients is largely similar. This mutation causes a benign myopathy within the range of previously reported Laing myopathy phenotype variations. Onset of weakness in the tibialis anterior (TA) muscles occurred in early childhood in all patients. Finger extensor and neck flexor weakness together with Achilles tendon retractions were other frequent findings. The independent recurrence of the identical mutation without any founder background may reflect a mutational susceptibility of this residue, in accordance with some other MYH7 mutations previously reported. De novo mutations seem to be frequent in Laing distal myopathy. This is of clinical importance since a dominant family history is missing, which may confuse differential diagnostic efforts.
Laing 早发性远端肌病是一种罕见的常染色体显性肌病,由编码慢肌球蛋白重链的 MYH7 基因突变引起。我们报道了首例由 MYH7 基因中的新型 p.Glu1508del 突变引起的法国家族性 Laing 远端肌病。有趣的是,我们在一个无关联的挪威家族和一个散发的芬兰患者中发现了相同的突变,且该突变为新生突变。详细描述了来自法国家族的 5 名患者的临床和电生理特征。芬兰患者和挪威患者的表型基本相似。该突变导致 Laing 肌病表型变异范围内的良性肌病。所有患者的胫骨前肌(TA)肌肉无力均在儿童早期出现。手指伸肌和颈部屈肌无力以及跟腱回缩也是常见表现。相同突变的独立复发而无任何创始人背景可能反映了该残基的突变易感性,与之前报道的一些其他 MYH7 突变一致。Laing 远端肌病中似乎经常发生新生突变。这具有临床重要性,因为缺乏显性家族史,这可能会混淆鉴别诊断的努力。