Homozygous recessive MYH2 mutation mimicking dominant MYH2 associated myopathy.

Homozygous recessive MYH2 mutation mimicking dominant MYH2 associated myopathy.
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DOI:
10.1016/j.nmd.2018.05.006
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发表时间:
2018-08
期刊:
Neuromuscular disorders : NMD
影响因子:
--
通讯作者:
Weihl CC
Weihl CC
中科院分区:
其他
文献类型:
--
作者:
Findlay AR;Harms MB;Pestronk A;Weihl CC

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编码肌球蛋白重链 IIa 的 MYH2 突变会导致显性和隐性遗传性肌病。具有显性遗传性 MYH2 错义突变的患者会出现眼肌麻痹和进行性近端肢体无力。肌肉活检显示边缘空泡和包涵体,促使该实体最初被描述为遗传性包涵体肌病 3。相反,具有隐性 MYH2 突变的患者具有早发、非进行性、弥漫性肌无力和眼肌麻痹。肌肉活检显示 2A 型纤维几乎或完全缺失,没有空泡或包涵体病理。我们描述了一名儿童期发病的眼肌麻痹患者,青春期开始进行性近端肌无力,肌肉活检显示肌病性改变和边缘空泡。尽管该患者的病程和组织病理学与显性 MYH2 突变一致,但全外显子组测序显示 c.737 G>A p.Arg246Thr 纯合 MYH2 变异。这些发现扩大了隐性 MYH2 肌病的临床和病理表型。
Mutations in MYH2 that encodes myosin heavy chain IIa cause both dominant and recessively inherited myopathies. Patients with dominantly inherited MYH2 missense mutations present with ophthalmoplegia and progressive proximal limb weakness. Muscle biopsy reveals rimmed vacuoles and inclusions, prompting this entity to initially be described as hereditary inclusion body myopathy 3. In contrast, patients with recessive MYH2 mutations have early onset, non-progressive, diffuse weakness and ophthalmoplegia. Muscle biopsy reveals near or complete absence of type 2A fibers with no vacuole or inclusion pathology. We describe a patient with childhood onset ophthalmoplegia, progressive proximal muscle weakness beginning in adolescence, and muscle biopsy with myopathic changes and rimmed vacuoles. Although this patient’s disease course and histopathology is consistent with dominant MYH2 mutations, whole exome sequencing revealed a c.737 G>A p.Arg246Thr homozygous MYH2 variant. These findings expand the clinical and pathologic phenotype of recessive MYH2 myopathies.
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