Jardine P E, Koch M C, Lunt P W, Maynard J, Bathke K D, Harper P S, Upadhyaya M
Institute of Child Health, Bristol.
Arch Dis Child. 1994 Sep;71(3):221-7. doi: 10.1136/adc.71.3.221.
Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant condition with variable age of onset and severity. Identification of a de novo DNA fragment by probe p13E-11 (D4F104S1) established the diagnosis of new mutation FSHD in 27 of 31 sporadic cases. The clinical data for these certain new mutation cases were as follows: 13 boys, 14 girls; mean age of onset 6.8 years; significant leg weakness in 19/27 (70%) (8/27 (30%) used wheelchairs at a mean age of 17.7 years); high tone sensorineural deafness in 10/27; visual acuity and direct ophthalmoscopy were normal. Congenital facial diplegia and sensorineural deafness in three children suggest that infantile FSHD is not a genetically separate disorder from FSHD. Ascertainment bias may explain the difference in severity between this group and typical familial cases. Molecular analysis for FSHD should be considered in children with either congenital or early onset facial weakness or diplegia.
面肩肱型肌营养不良症(FSHD)是一种常染色体显性疾病,发病年龄和严重程度各不相同。通过探针p13E - 11(D4F104S1)鉴定出一个新生DNA片段,在31例散发病例中的27例中确诊了新突变型FSHD。这些特定新突变病例的临床数据如下:男孩13例,女孩14例;平均发病年龄6.8岁;19/27(70%)有明显的腿部无力(8/27(30%)在平均17.7岁时使用轮椅);10/27有高调感音神经性耳聋;视力和直接检眼镜检查正常。三个儿童出现先天性面瘫和感音神经性耳聋,提示婴儿型FSHD与FSHD在遗传上并非独立的疾病。确诊偏倚可能解释了该组病例与典型家族性病例在严重程度上的差异。对于患有先天性或早发性面部无力或面瘫的儿童,应考虑进行FSHD的分子分析。