Yamamoto Daisuke, Oda Ryosuke, Hisahara Shin, Ishikawa Aki, Ogi Tomoo, Shimohama Shun
Department of Neurology, Sapporo Medical University School of Medicine.
Department of Medical Genetics and Genomics, Sapporo Medical University School of Medicine.
Rinsho Shinkeigaku. 2021 Apr 21;61(4):262-264. doi: 10.5692/clinicalneurol.cn-001542. Epub 2021 Mar 25.
A 33-year-old man with an unremarkable family history has had limb muscle weakness, joint contracture and skeleton deformation from early childhood. He was diagnosed with spinal muscular atrophy (SMA) by a pediatrician. He needed assistance and used orthoses in his daily life. There was no subjective sensory disturbance. However, physical examination showed slight sensory impairment, and nerve conduction study indicated sensory motor axonal neuropathy. This finding suggested Charcot-Marie-Tooth disease (CMT). Gene analysis detected MORC2 S87L mutation, leading to a diagnosis of CMT type 2Z. Patients with MORC2 S87L mutation are known to exhibit a severe phenotype, and may mimic SMA. It is important to demonstrate subclinical sensory neuropathy in patients with MORC2 S87L mutation mimicking SMA.
一名33岁男性,家族史无异常,自幼出现肢体肌肉无力、关节挛缩和骨骼变形。儿科医生诊断为脊髓性肌萎缩症(SMA)。他在日常生活中需要协助并使用矫形器。无主观感觉障碍。然而,体格检查显示有轻微感觉障碍,神经传导研究提示感觉运动轴索性神经病。这一发现提示为夏科-马里-图斯病(CMT)。基因分析检测到MORC2 S87L突变,从而诊断为2Z型CMT。已知携带MORC2 S87L突变的患者表现为严重表型,可能类似SMA。对于表现类似SMA的MORC2 S87L突变患者,证实存在亚临床感觉神经病很重要。