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A rare case of centronuclear myopathy with DNM2 mutation: genotype–phenotype correlation

机译:罕见的DNM2突变的中心核肌病:基因型与表型的相关性

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Centronuclear myopathy (CNM) is a group of rare genetic muscle disorders characterized by muscle fibers with centrally located nuclei. The most common forms of CNM have been attributed to X-linked recessive mutations in the MTM1 gene; autosomal-dominant mutations in the DNM2 gene-encoding dynamin-2, the BIN1 gene; and autosomal-recessive mutations in BIN1, RYR1, and TTN genes. Dominant CNM due to DNM2 mutations usually follows a mild clinical course with the onset in adolescence. Currently, around 35 mutations of the DNM2 gene have been identified in CNM; however, the underlying molecular mechanism of DNM2 mutation in the pathology of CNM remains elusive, and the standard clinical characteristics have not yet been defined. Here, we describe the case of a 17-year-old female who presented with proximal muscle weakness along with congenital anomalous pulmonary venous connection (which has not been described in previous cases of CNM), scoliosis, and lung disease without a significant family history. Her creatine kinase level was normal. Histology, special stains, and electron microscope findings on her skeletal muscle biopsy showed CNM with the characteristic features of a DNM2 mutation, which was later confirmed by next-generation sequencing. This case expands the known clinical and pathological findings of CNM with DNM2 gene mutation.
机译:中心核肌病(CNM)是一组罕见的遗传性肌肉疾病,其特征是肌肉纤维位于中央。 CNM的最常见形式归因于MTM1基因中的X连锁隐性突变。 DNM2基因编码dynamin-2(BIN1基因)中的常染色体显性突变;和BIN1,RYR1和TTN基因的常染色体隐性突变。由于DNM2突变而导致的主要CNM通常遵循轻度的临床过程,并在青春期发作。目前,在CNM中已经鉴定出DNM2基因的约35个突变。然而,在CNM病理学中DNM2突变的潜在分子机制仍然难以捉摸,并且尚未定义标准的临床特征。在这里,我们描述了一名17岁女性的病例,该女性伴有近端肌肉无力以及先天性异常肺静脉连接(在先前的CNM病例中未描述),脊柱侧弯和肺部疾病,无明显家族史。她的肌酸激酶水平正常。在她的骨骼肌活检中的组织学,特殊染色和电子显微镜检查结果显示,CNM具有DNM2突变的特征,后来被下一代测序证实。这种情况扩大了具有DNM2基因突变的CNM的已知临床和病理学发现。

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