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基因检测揭示杜氏肌营养不良症患者并存的神经肌肉疾病

Genetic Panel Reveals Coexisting Neuromuscular Disorders in Patients With Duchenne Muscular Dystrophy.

作者信息

Butson Carter, Ntekim Nedeke, Acord Stephanie, Marks Warren

机构信息

Texas College of Osteopathic Medicine, UNT Health Science Center, Fort Worth, TX, USA.

Department of Neurology, Cook Children's Medical Center, Fort Worth, TX, USA.

出版信息

J Child Neurol. 2025 Feb;40(2):83-90. doi: 10.1177/08830738241284683. Epub 2024 Oct 21.

Abstract

Duchenne muscular dystrophy is a genetically based neuromuscular disorder characterized by progressive physical impairment and cardiomyopathy in children, leading to fatal cardiac or respiratory failure. Duchenne muscular dystrophy shares some overlapping clinical features with other disorders, complicating clinical differentiation. We hypothesized that some Duchenne muscular dystrophy patients may have a secondary neuromuscular disorders that could negatively skew data during pharmaceutical clinical trials and lead to incomplete treatment plans. Consecutive genetic panels on 353 patients were reviewed. Thirty-two (32; 9.1%) patients with Duchenne muscular dystrophy were identified. Three (3; 9.4%) were found to have at least 1 genetically confirmed secondary neuromuscular disorder. Overlooking these coexisting disorders could lead to unexpected treatment failures, potentially affecting medication efficacy in trials or commercial use. Secondary neuromuscular disorders should be considered in Duchenne muscular dystrophy patients before clinical trial enrollment or treatment planning, with expanded genetic testing, such as whole exome sequencing or whole genome sequencing, likely to reveal even more secondary disorders.

摘要

杜兴氏肌肉营养不良症是一种基于基因的神经肌肉疾病,其特征为儿童出现进行性身体损伤和心肌病,最终导致致命的心脏或呼吸衰竭。杜兴氏肌肉营养不良症与其他疾病有一些重叠的临床特征,这使得临床鉴别变得复杂。我们推测,一些杜兴氏肌肉营养不良症患者可能患有继发性神经肌肉疾病,这可能会在药物临床试验期间对数据产生负面影响,并导致治疗方案不完整。我们回顾了353名患者的连续基因检测结果。确定了32名(32;9.1%)杜兴氏肌肉营养不良症患者。其中3名(3;9.4%)被发现至少有一种经基因确认的继发性神经肌肉疾病。忽视这些共存疾病可能导致意外的治疗失败,这可能会影响试验或商业用途中的药物疗效。在杜兴氏肌肉营养不良症患者进行临床试验入组或治疗规划之前,应考虑继发性神经肌肉疾病,扩大基因检测,如全外显子组测序或全基因组测序,可能会发现更多的继发性疾病。

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