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Muscle magnetic resonance imaging abnormalities in X‐linked myopathy with excessive autophagy
Authors:Sandra Mercier MD  PhD  Armelle Magot MD  Florence Caillon MD  Bertrand Isidor MD  Albert David MD  Xavier Ferrer MD  Anne Vital MD  PhD  Michelle Coquet MD  Sini Penttilä MD  Bjarne Udd MD  PhD  Jean‐Marie Mussini MD  Yann Pereon MD  PhD
Affiliation:1. Service de Génétique Médicale, H?pital Mre‐Enfant, Nantes, France;2. Centre de Référence Maladies Neuromusculaires Nantes, Angers, H?tel‐Dieu, Nantes cedex, France;3. Atlantic Gene Therapy, Biotherapy Institute for Rare Diseases, Nantes, France;4. Laboratoire d'Explorations Fonctionnelles, H?tel‐Dieu, Nantes, France;5. Service de Radiologie Centrale, H?tel‐Dieu, Nantes, France;6. Centre de Référence Maladies Neuromusculaires, CHU de Bordeaux, Bordeaux, France;7. Neuromuscular Research Center, Tampere University and University Hospital Tampere, Finland;8. Folkhalsan Institute of Genetics, Helsinki, Finland;9. Vasa Central Hospital, Vasa, Finland;10. Laboratoire d'Anatomie Pathologique, H?tel‐Dieu, Nantes, France
Abstract:Introduction: X‐linked myopathy with excessive autophagy (XMEA) is an X‐linked recessive myopathy due to recently reported mutations in the VMA21 gene. Methods: Four men from 2 separate families were studied. The clinical presentation, genetic data, muscle biopsy, and muscle MRI were analyzed. Results: A known VMA21 mutation, c.163+4A>G, and a new mutation, c.163+3A>G, respectively, were found in the 2 families. The clinical course was characterized by onset in childhood and progressive muscle weakness with a limb‐girdle pattern. Muscle biopsy revealed a mild myopathy with an increased number of giant autophagic vacuoles. Whole‐body muscle MRI showed that pelvic girdle and proximal thighs were the most and earliest affected territories, with sparing of rectus femoris muscles. Muscle changes essentially consisted of degenerative fatty replacement. Conclusions: This study highlights a distinctive MRI pattern of muscle involvement, which can be helpful for diagnosis of XMEA, even before muscle biopsy or genetic analysis. Muscle Nerve 52: 673–680, 2015
Keywords:excessive autophagy  muscle MRI  myopathy  VMA21  XMEA
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