Key result
Novel autosomal dominant distal myopathy presents with tibialis anterior weakness and early respiratory failure.
Observational (n=24)
Describes a novel, genetically distinct autosomal dominant distal myopathy characterized by early respiratory failure and specific muscle pathology.
Alerts clinicians to consider this entity in distal myopathy with early respiratory failure; leaves open validation in larger cohorts.
We describe a novel autosomal dominant myopathy presenting in mid-adult life with tibialis anterior weakness. We carried out a detailed clinical assessment of 24 individuals spanning three generations, documenting pathologic features of the muscles in 7 of the 11 affected individuals, including an autopsy study on one case. The second generation of affected individuals presented at an earlier age, and the disease progressed more rapidly than in the first generation. Lung function tests revealed progressive global respiratory muscle weakness detectable from the time of presentation, with preferential diaphragmatic involvement in some cases. Hip girdle and shoulder girdle weakness appeared later in the disease course. We observed a striking correlation between the clinical and pathological features. Clinically unaffected muscles had minimal pathologic change. Fiber splitting, eosinophilic inclusions, and vacuoles with basophilic rims were seen in moderately affected muscles, and fat and fibrous connective tissue replaced muscle fibers in the severely involved muscles. The inclusions were Congophilic and reacted with antibodies to desmin, beta-amyloid, and phosphorylated tau protein. The disease was not linked to any of the known loci associated with distal myopathies, confirming that the disorder in this family is both genetically and phenotypically distinct.
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Chinnery et al. (2001) conducted an observational in Autosomal dominant distal myopathy with early respiratory failure (n=24). Novel autosomal dominant distal myopathy was evaluated on Clinical and pathologic characteristics, and genetic linkage. A novel autosomal dominant distal myopathy presenting with tibialis anterior weakness and early respiratory failure was identified, showing distinct genetic and phenotypic characteristics.
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