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含缬酪肽蛋白(VCP)病的临床谱

Clinical spectrum of valosin containing protein (VCP)-opathy.

作者信息

Kazamel Mohamed, Sorenson Eric J, McEvoy Kathleen M, Jones Lyell K, Leep-Hunderfund Andrea N, Mauermann Michelle L, Milone Margherita

机构信息

Department of Neurology, Mayo Clinic, Rochester, Minnesota, 55905, USA.

出版信息

Muscle Nerve. 2016 Jun;54(1):94-9. doi: 10.1002/mus.24980. Epub 2015 Dec 29.

Abstract

INTRODUCTION

Valosin containing protein (VCP) mutations cause a rare disorder characterized by hereditary inclusion body myopathy, Paget disease of bone (PDB), and frontotemporal dementia (FTD) with variable penetrance. VCP mutations have also been linked to amyotrophic lateral sclerosis and Charcot-Marie-Tooth disease type 2.

METHODS

Review of clinical, serological, electrophysiological, and myopathological findings of 6 VCP-opathy patients from 4 unrelated families.

RESULTS

Patients manifested muscle weakness between ages 40 and 53 years and developed predominant asymmetric limb girdle weakness. One patient had distal weakness at onset and co-existing peripheral neuropathy. Another patient had PDB, 1 had mild cognitive deficits, and 1 had FTD. All patients had myopathic and neurogenic electromyographic findings with predominant neurogenic changes in 2. Rimmed vacuoles were infrequent, while neurogenic changes were prominent in muscle biopsies.

CONCLUSIONS

VCP-opathy is a multifaceted disorder in which myopathy and peripheral neuropathy can coexist. The electrophysiological and pathological neurogenic changes raise the possibility of coexisting motor neuron involvement. Muscle Nerve, 2015 Muscle Nerve 54: 94-99, 2016 Muscle Nerve 54: 94-99, 2016.

摘要

引言

含缬酪肽蛋白(VCP)突变会引发一种罕见疾病,其特征为遗传性包涵体肌病、骨佩吉特病(PDB)和具有可变外显率的额颞叶痴呆(FTD)。VCP突变还与肌萎缩侧索硬化症和2型夏科-马里-图斯病有关。

方法

回顾来自4个无关家庭的6例VCP病患者的临床、血清学、电生理和肌病理学检查结果。

结果

患者在40至53岁之间出现肌无力,主要表现为不对称性肢带肌无力。1例患者起病时出现远端肌无力并伴有周围神经病变。另1例患者患有PDB,1例有轻度认知缺陷,1例患有FTD。所有患者的肌电图和神经电图检查结果均显示既有肌源性改变又有神经源性改变,其中2例以神经源性改变为主。镶边空泡较少见,而神经源性改变在肌肉活检中较为突出。

结论

VCP病是一种多方面的疾病,其中肌病和周围神经病变可能并存。电生理和病理神经源性改变增加了运动神经元同时受累的可能性。《肌肉与神经》,2015年《肌肉与神经》54: 94 - 99,2016年《肌肉与神经》54: 94 - 99,2016年

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