Preview

L.O. Badalyan Neurological Journal

Advanced search

A clinical case of severe Duchenne muscular dystrophy caused by a nonsense mutation in the DMD gene in a girl

https://doi.org/10.46563/2686-8997-2021-2-4-227-232

Abstract

Summary. Duchenne muscular dystrophy (DMD) is a hereditary progressive muscular dystrophy, mainly manifested in boys, is characterized by the onset at an early age, gradual symmetrical atrophy of the striated musculature of the limbs, trunk, as well as damage to the heart muscle. As a rule, girls and women inheriting a pathological mutation are classified only as its carriers and do not have clinical manifestations of the disease. Rare cases when women or girls show clinical manifestations of DMD may be due to chromosomal rearrangements involving the region of the short arm of the X chromosome (Xp21.2), deletions of this region, complete loss of the X chromosome (Shereshevsky-Turner syndrome), homogenous X chromosome dysomnia, compound heterozygous state for two pathogenic mutations in the DMD gene, nonequilibrium inactivation of the X chromosome.

When female mutation carriers have DMD clinical symptoms, they usually manifest much milder than boys and young males. Descriptions of patients with the severe course and rapid progression of the disease, comparable in the rate of progression with boys, are rare. In this article, the authors share their experience of observing a girl patient who suffered from a severe form of DMD.

About the Authors

Tatyana V. Podkletnova
National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation
Russian Federation

MD, PhD, Senior Researcher, Laboratory of Nervous Diseases, National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation, Moscow, 119991, Russian Federation.

e-mail: podkletnova.tv@nczd.ru



Olga B. Kondakova
National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation
Russian Federation


Eugeniya V. Uvakina
National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation
Russian Federation


Dariya A. Fisenko
Central State Medical Academy of the Presidential Administration of the Russian Federation
Russian Federation


Anastasiya A. Lyalina
National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation
Russian Federation


Sophiya G. Popovich
National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation
Russian Federation


Lyudmila M. Kuzenkova
National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation
Russian Federation


Aleksey L. Kurenkov
National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation
Russian Federation


Lale A. Pak
National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation
Russian Federation


Bella I. Bursagova
National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation
Russian Federation


References

1. Fornander F., Solheim T.Å., Eisum A.V., Poulsen N.S., Andersen A.G.,

2. Dahlqvist J.R., et al. Quantitative muscle MRI and clinical findings in women with pathogenic dystrophin gene variants. Front. Neurol. 2021; 12: 707837. https://doi.org/10.3389/fneur.2021.707837

3. Nair D.G., Lorenzo N. Dystrophinopathies Workup. Medscape. Available at: https://emedicine.medscape.com/article/1173204-workup

4. Duan D., Goemans N., Takeda S., Mercuri E., Aartsma-Rus A. Duchenne muscular dystrophy. Nat. Rev. Dis. Primers. 2021; 7(1): 13. https://doi.org/10.1038/s41572-021-00248-3

5. Aartsma-Rus A., Hegde M., Ben-Omran T., Buccella F., Ferlini A.,

6. Gallano P., et al. Evidence-based consensus and systematic review on reducing the time to diagnosis of Duchenne muscular dystrophy. J. Pediatr. 2019; 204: 305–13.e14. https://doi.org/10.1016/j.jpeds.2018.10.043

7. Juan-Mateu J., Rodríguez M.J., Nascimento A., Jiménez-Mallebrera C., González-Quereda L., Rivas E., et al. Prognostic value of X-chromosome inactivation in symptomatic female carriers of dystrophinopathy. Orphanet. J. Rare Dis. 2012; 7: 82. https://doi.org/10.1186/1750-1172-7-82

8. Bushby K., Finkel R., Birnkrant D.J., Case L.E., Clemens P.R., Cripe L.,

9. et al. DMD Care Considerations Working Group. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. Lancet Neurol. 2010; 9(1): 77–93. https://doi.org/10.1016/S1474-4422(09)70271-6

10. Hoogerwaard E.M., Bakker E., Ippel P.F., Oosterwijk J.C., Majoor-Krakauer D.F., Leschot N.J., et al. Signs and symptoms of Duchenne muscular dystrophy and Becker muscular dystrophy among carriers in The Netherlands: a cohort study. Lancet. 1999; 353(9170): 2116–9. https://doi.org/10.1016/s0140-6736(98)10028-4

11. Silva T.H.D., Anequini I.P., Fávero F.M., Voos M.C., Oliveira A.S.B., Telles J.A.R., et al. Functional performance and muscular strength in symptomatic female carriers of Duchenne muscular dystrophy. Arq. Neuropsiquiatr. 2020; 78(3): 143–8. https://doi.org/10.1590/0004-282X20190168

12. Giglio V., Puddu P.E., Camastra G., Sbarbati S., Della Sala S.W., Ferlini A., et al. Patterns of late gadolinium enhancement in Duchenne muscular dystrophy carriers. J. Cardiovasc. Magn. Reson. 2014; 16(1): 45. https://doi.org/10.1186/1532-429X-16-45

13. Papa R., Madia F., Bartolomeo D., Trucco F., Pedemonte M., Traverso M., et al. Genetic and early clinical manifestations of females heterozygous for Duchenne/Becker muscular dystrophy. Pediatr. Neurol. 2016; 55: 58–63. https://doi.org/10.1016/j.pediatrneurol.2015.11.004

14. Preuße C., von Moers A., Kölbel H., Pehl D., Goebel H.H., Schara U., et al. Inflammation-induced fibrosis in skeletal muscle of female carriers of Duchenne muscular dystrophy. Neuromuscul. Disord. 2019; 29(7): 487–96. https://doi.org/10.1016/j.nmd.2019.05.003

15. Birnkrant D.J., Bushby K., Bann C.M., Apkon S.D., Blackwell A., Brumbaugh D., et al. DMD Care Considerations Working Group. Diagnosis and management of Duchenne muscular dystrophy, part 1:

16. diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. Lancet Neurol. 2018; 17(3): 251–67. https://doi.org/10.1016/S1474-4422(18)30024-3

17. D’Ambrosio P., Orsini C., Nigro V., Politano L. Therapeutic approach with Ataluren in Duchenne symptomatic carriers with nonsense mutations in dystrophin gene. Results of a 9-month follow-up in a case report. Acta Myol. 2018; 37(4): 272–4.

18. Muntoni F., Desguerre I., Guglieri M., Osorio A.N., Kirschner J., Tulinius M., et al. Ataluren use in patients with nonsense mutation Duchenne muscular dystrophy: patient demographics and characteristics from the STRIDE Registry. J. Comp. Eff. Res. 2019; 8(14): 1187–200. https://doi.org/10.2217/cer-2019-0086

19. Nozoe K.T., Akamine R.T., Mazzotti D.R., Polesel D.N., Grossklauss L.F., Tufik S., et al. Phenotypic contrasts of Duchenne Muscular Dystrophy in women: Two case reports. Sleep Sci. 2016; 9(3): 129–33. https://doi.org/10.1016/j.slsci.2016.07.004

20. Duan D., Goemans N., Takeda S., Mercuri E., Aartsma-Rus A. Duchenne muscular dystrophy. Nat. Rev. Dis. Primers. 2021; 7(1): 13. https://doi.org/10.1038/s41572-021-00248-3

21. Darras B.T., Urion D.K., Ghosh P.S. Dystrophinopathies. In: Adam M.P.,

22. Ardinger H.H., Pagon R.A., Wallace S.E., Bean L.J.H., Mirzaa G., eds. GeneReviews®. Seattle: University of Washington; 2000.

23. Voinova V.Yu., Yurov I.Yu., Vorsanova S.G., Yurov Yu.B. Mental Retardation and the X Chromosome [Umstvennaya otstalost’ i khromosoma X]. Moscow; 2016. (in Russian)


Review

For citations:


Podkletnova T.V., Kondakova O.B., Uvakina E.V., Fisenko D.A., Lyalina A.A., Popovich S.G., Kuzenkova L.M., Kurenkov A.L., Pak L.A., Bursagova B.I. A clinical case of severe Duchenne muscular dystrophy caused by a nonsense mutation in the DMD gene in a girl. L.O. Badalyan Neurological Journal. 2021;2(4):227-232. (In Russ.) https://doi.org/10.46563/2686-8997-2021-2-4-227-232

Views: 807


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2686-8997 (Print)
ISSN 2712-794X (Online)