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Dystrophinopathy in two young boys with exercise-induced cramps and myoglobinuria

  • Neuropediatrics
  • Published:
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Abstract

Two young boys were referred for evaluation of metabolic myopathy because of elevated serum levels of creatine kinase, cramps and pigmenturia. Immunohistochemical studies of dystrophin in muscle biopsies showed reduced intensity of the stain with a patchy and discontinous pattern in most fibers. In both patients dystrophin was undetectable by immunoblotting. DNA analysis of the dystrophin gene was not informative in one patient; in the other it revealed an in-frame deletion comprising exons 3–6. These observations suggest that the two patients are affected with an unusual phenotype of Becker muscular dystrophy. Dystrophin analysis should be included in the evaluation of patients with childhood-onset of recurrent myoglobinuria.

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Abbreviations

BMD:

Becker muscular dystrophy

CK:

creatine kinase

CPT:

carnitine palmitoyl transferase

DMD:

Duchenne muscular dystrophy

PCR:

polymeras chain reaction

PFK:

phosphofructokinase

References

  1. Beggs AH, Koenig M, Boyce FM, Kunkel LM (1990) Detection of 98% of DMD/BMD gene deletions by polymerase chain reaction. Hum Genet 86:45–48

    PubMed  Google Scholar 

  2. Beggs AH, Hoffman EP, Snyder JR, et al (1991) Exploring the molecular basis for variability among patients with Becker muscular dystrophy: dystrophin gene and protein studies. Am J Hum Genet 99:54–67

    Google Scholar 

  3. Bradley WG, Jones MZ, Mussini JM, Fawcett PRW (1978) Becker-type muscular dystrophy. Muscle Nerve 1:111–132

    PubMed  Google Scholar 

  4. Chamberlain JS, Gibbs RA, Ranier JE, Caskey CT (1989) Multiplex PCR for the diagnosis of Duchenne muscular dystrophy. In. Innis M, Getland D, Sninsky J, White T (eds) PCR protocols: a guide to methods and applications. Academic Press, Orlando, pp 272–281

    Google Scholar 

  5. Chang HW, Bock E, Bonilla E (1989) Dystrophin in electric organ of Torpedo californica homologous to that in human muscle. J Biol Chem 264:20831–20834

    PubMed  Google Scholar 

  6. Gold R, Kress W, Meurers B, Meng G, Reichman H, Muller CR (1992) Becker muscular dystrophy: detection of unusual disease courses b combined approach to dystrophin analysis. Muscle Nerve 15:214–218

    PubMed  Google Scholar 

  7. Gospe SM, Lazaro RP, Lava NS, et al (1989) Familial X-linked myalgia and cramps: a non-progressive myopathy associated with a deletion in the dystrophin gene. Neurology 39:1277–1280

    PubMed  Google Scholar 

  8. Heiman-Patterson TD, Natter HM, Rosenberg H, Fletcher JE, Tahmoush AJ (1986) Malignant hyperthermia susceptibility in X-linked muscle dystrophies. Pediatr Neurol 2:356–358

    PubMed  Google Scholar 

  9. Hoffman EP, Brown RH, Kunkel LM (1987) Dystrophin: the protein product of the Duchenne muscular dystrophy locus. Cell 51:919–992

    PubMed  Google Scholar 

  10. Hoffman EP, Fischbeck KH, Brown RH, et al (1988) Dystrophin characterization in muscle biopsies from Duchenne and Becker muscular dystrophy patients. N Engl J Med 318:1363–1368

    PubMed  Google Scholar 

  11. Hoffman EP, Kunkel LM, Angelini C, Clarke A, Johnson M, Harris JB (1989) Improved diagnosis of Becker muscular dystrophy by dystrophin testing. Neurology 39:1011–1017

    PubMed  Google Scholar 

  12. Hu X, Ray PN, Murphy EG, Thompson MW, Worton RG (1990) Duplication mutation at the Duchenne muscular dystrophy locus: its frequency, distribution, origin and phenotype/genotype correlation. Am J Hum Genet 46:682–695

    PubMed  Google Scholar 

  13. Koenig M, Monaco AP, Kunkel LM (1988) The complete sequence of dystrophin predicts a rod-shaped cytoskeletal protein. Cell 53:219–228

    PubMed  Google Scholar 

  14. Medori R, Brooke MH, Waterson RH (1989) Two dissimilar brothers with Becker muscular dystrophy have an identical genetic defect. Neurology 39:1493–1496

    PubMed  Google Scholar 

  15. Minetti C, Chang HW, Medori R, et al (1991) Dystrophin deficiency in young girls with sporadic myopathy and normal karyotype. Neurology 41:1288–1292

    PubMed  Google Scholar 

  16. Monaco AP, Bertelson CJ, Liechti-Gallati S, Moser H, Kunkel LM (1988) An explanation for the phenotypic differences between patients bearing partial deletions of the DMD locus. Genomics 2:90–95

    PubMed  Google Scholar 

  17. Nicholson LVB, Johnson MA, Gardner-Medwin D, Bhattacharya S, Harris JB (1990) Heterogeneity of dystrophin expression in patients with Duchenne and Becker muscular dystrophy. Acta Neuropathol 80:239–250

    PubMed  Google Scholar 

  18. Sunohara N, Arahata K, Hoffman EP, et al (1990) Quadriceps myopathy: a forme fruste of Becker muscular dystrophy. Ann Neurol 27:181–185

    PubMed  Google Scholar 

  19. Tein I, DiMauro S, DeVivo DC (1990) Recurrent childhood myoglobinura. Adv Pediatr 37:77–117

    PubMed  Google Scholar 

  20. Tonin P, Lewis P, Servidei S, DiMauro S (1990) Metabolic causes of myoglobinuria. Ann Neurol 27:181–185

    PubMed  Google Scholar 

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Minetti, C., Tanji, K., Chang, H.W. et al. Dystrophinopathy in two young boys with exercise-induced cramps and myoglobinuria. Eur J Pediatr 152, 848–851 (1993). https://doi.org/10.1007/BF02073385

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  • DOI: https://doi.org/10.1007/BF02073385

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