Park Eun-Woo, Shim Ye-Jee, Ha Jung-Sook, Shin Jin-Hong, Lee Soyoung, Cho Jang-Hyuk
Department of Rehabilitation Medicine, Keimyung University Dongsan Hospital, Keimyung University school of Medicine, Daegu 42601, Korea.
Department of Pediatrics, Keimyung University Dongsan Hospital, Keimyung University school of Medicine, Daegu 42601, Korea.
Children (Basel). 2021 May 11;8(5):377. doi: 10.3390/children8050377.
Duchenne muscular dystrophy is a progressive and lethal X-linked recessive neuromuscular disease caused by mutations in the dystrophin gene. It has a high rate of diagnostic delay; early diagnosis and treatment are often not possible due to delayed recognition of muscle weakness and lack of effective treatments. Current treatments based on genetic therapy can improve clinical results, but treatment must begin as early as possible before significant muscle damage. Therefore, early diagnosis and rehabilitation of Duchenne muscular dystrophy are needed before symptom aggravation. Creatine kinase is a diagnostic marker of neuromuscular disorders. Herein, the authors report a case of an infant patient with Duchenne muscular dystrophy with a highly elevated creatine kinase level but no obvious symptoms of muscle weakness. The patient was diagnosed with Duchenne muscular dystrophy via next-generation sequencing and chromosomal microarray analysis to identify possible inherited metabolic and neuromuscular diseases related to profound hyperCKemia. The patient is enrolled in a rehabilitation program and awaits the approval of the genetic treatment in Korea. This is the first report of an infantile presymptomatic Duchenne muscular dystrophy diagnosis using next-generation sequencing and chromosomal microarray analysis.
杜氏肌营养不良症是一种进行性致死性X连锁隐性神经肌肉疾病,由肌营养不良蛋白基因突变引起。其诊断延迟率很高;由于对肌肉无力的认识延迟以及缺乏有效治疗方法,早期诊断和治疗往往无法实现。目前基于基因治疗的方法可以改善临床结果,但治疗必须在出现明显肌肉损伤之前尽早开始。因此,需要在症状加重之前对杜氏肌营养不良症进行早期诊断和康复治疗。肌酸激酶是神经肌肉疾病的诊断标志物。在此,作者报告了一例杜氏肌营养不良症婴儿患者,其肌酸激酶水平大幅升高,但无明显肌肉无力症状。通过下一代测序和染色体微阵列分析诊断该患者患有杜氏肌营养不良症,以确定可能与严重高肌酸激酶血症相关的遗传性代谢和神经肌肉疾病。该患者已参加康复项目,正在等待韩国基因治疗的批准。这是首例使用下一代测序和染色体微阵列分析诊断婴儿期无症状杜氏肌营养不良症的报告。