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Novel diagnostic features of dysferlinopathies
Authors:Xiomara Q Rosales MD  Julie M Gastier‐Foster PhD  Sarah Lewis HT  ASCP  Malik Vinod PhD  Devon L Thrush MS  Caroline Astbury PhD  Robert Pyatt PhD  Shalini Reshmi PhD  Zarife Sahenk MD  PhD  Jerry R Mendell MD
Institution:1. Department of Pediatrics, Neuromuscular Division, Nationwide Children's Hospital, Columbus, Ohio, USA;2. Center for Gene Therapy, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA;3. Department of Pediatrics, Ohio State University, Columbus, Ohio, USA;4. Department of Neurology, Neuromuscular Division, Ohio State University, Columbus, Ohio, USA;5. Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
Abstract:Reports of dysferlinopathy have suggested a clinically heterogeneous group of patients. We identified specific novel molecular and phenotypic features that help distinguish dysferlinopathies from other forms of limb‐girdle muscular dystrophy (LGMD). A detailed history, physical exam, and protein and mutation analysis of genomic DNA was done for all subjects. Five of 21 confirmed DYSF gene mutations were not previously reported. A distinct “bulge” of the deltoid muscle in combination with other findings was a striking feature in all patients. Six subjects had atypical calf enlargement, and 3 of these exhibited a paradoxical pattern of dysferlin expression: severely reduced by direct immunofluorescence with overexpression on Western blots. Six patients showed amyloid deposits in muscle that extended these findings to new domains of the dysferlin gene, including the C2G domain. Correlative studies showed colocalization of amyloid with deposition of dysferlin. The present data further serve to guide clinicians facing the expensive task of molecular characterization of patients with an LGMD phenotype. Muscle Nerve 42: 14–21, 2010
Keywords:amyloid  calf myopathy  dysferlin  LGMD2B  muscular dystrophy
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