Kim Jaewon, Lee Dong-Woo, Jang Ja-Hyun, Kim Myungshin, Yim Jisook, Jang Dae-Hyun
Department of Rehabilitation Medicine, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Front Pediatr. 2021 Feb 26;9:628190. doi: 10.3389/fped.2021.628190. eCollection 2021.
Herein, we present a rare case of co-occurring Duchenne muscular dystrophy (DMD) and frontometaphyseal dysplasia 1 (FMD1), two different X-linked diseases, in a 7-year-old boy. He presented with proximal muscle weakness and elevated creatine phosphokinase levels. A multiplex ligation-dependent probe amplification study of revealed the duplications of exons 2-37, thereby confirming the diagnosis of DMD. Initial evaluation revealed atypical features, such as facial dysmorphism, multiple joint contractures, and severe scoliosis, at an early age. However, these were overlooked and were assumed to be atypical manifestations of DMD. Then, the patient's maternal cousin was diagnosed with FMD1 with pathogenic missense variant in (NM_001110556.2: c.3557C>T/p.Ser1186Leu). A family genetic test revealed that the patient and his mother had the same pathogenic variant in . The patient's atypical manifestations were considered symptoms of FMD1. Therefore, if one disease does not fully explain the patient's clinical features, an expanded genetic study is needed to detect coincidental disease.
在此,我们报告一例罕见病例,一名7岁男孩同时患有杜氏肌营养不良症(DMD)和额骨干骺端发育不良1型(FMD1),这是两种不同的X连锁疾病。他表现为近端肌无力和肌酸磷酸激酶水平升高。多重连接依赖探针扩增研究显示外显子2 - 37重复,从而确诊为DMD。初始评估发现该患儿在幼年时就有非典型特征,如面部畸形、多处关节挛缩和严重脊柱侧弯。然而,这些特征被忽视了,并被认为是DMD的非典型表现。随后,患者母亲的表弟被诊断为FMD1,存在 (NM_001110556.2: c.3557C>T/p.Ser1186Leu)的致病性错义变异。家族基因检测显示患者及其母亲在 存在相同的致病性变异。患者的非典型表现被认为是FMD1的症状。因此,如果一种疾病不能完全解释患者的临床特征,就需要进行扩展的基因研究以检测是否存在并发疾病。