Clinical phenotype in congenital muscular dystrophy: correlation with expression of merosin in skeletal

https://doi.org/10.1016/0960-8966(94)00069-LGet rights and content

Abstract

It has recently been shown that merosin, an extracellular matrix protein linked to the dystrophin-associated glycoproteins, is deficient in a proportion of patients with classical congenital muscular dystrophy (CMD). We have undertaken a detailed study of the clinical features and brain imaging in 24 cases of CMD in relation to the merosin status.

Immunocytochemistry showed that merosin was present in 13 cases and markedly deficient in 11. In the merosin-positive cases, the maximum motor achievement was independent walking in 11, walking with support in one and sitting unsupported in one (currently 18 months old). In contrast, none of the merosin-deficient cases achieved independent ambulation. Two achieved walking with support, nine standing with support. In addition, nine of the 11 merosin-deficient cases had a creatine kinase level greater than 2000 whereas only one merosin-positive case had this degree of elevation.

Magnetic resonance imaging of the brain was carried out on 15 of the children. All eight merosin-positive cases had normal scans whereas all seven of the merosin-deficient cases had significant changes in the white matter.

This study has demonstrated that children with merosin-deficient CMD have a more severe clinical phenotype and associated white matter changes on brain imaging.

References (12)

There are more references available in the full text version of this article.

Cited by (177)

  • Neonatal hypotonia and neuromuscular conditions

    2019, Handbook of Clinical Neurology
    Citation Excerpt :

    Progressive enlargement of the ventricles, however, is less frequent and only a minority will require shunt placement. This is a heterogeneous group of neuromuscular disorders characterized by weakness, usually from birth, or within 6 months, and dystrophic changes on muscle biopsy (Dubowitz, 1994; Philpot et al., 1995). Over the years the classification of CMD has become increasingly complicated due to the ever-growing numbers of genes and proteins identified (Muntoni and Voit, 2004; Mercuri and Longman, 2005; Godfrey et al., 2007).

  • Hypotonia and Weakness: Level of the Muscle

    2018, Volpe's Neurology of the Newborn
  • Neonatal Neuromuscular Disorders

    2018, Avery's Diseases of the Newborn: Tenth Edition
  • Neonatal Neuromuscular Disorders

    2017, Avery's Diseases of the Newborn, Tenth Edition
View all citing articles on Scopus
View full text