Desmin-related myofibrillar myopathy
| Desmin-related myofibrillar myopathy | |
| Classification and external resources | |
| OMIM | 601419 |
|---|---|
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Desmin-related myofibrillar myopathy is a subgroup of the myofibrillar myopathy diseases and is the result of a mutation in the gene that codes for desmin which prevents it from forming protein filaments, instead forming aggregates of desmin and other proteins throughout the cell.[1]
Pathophysiology
The sarcomeres become misaligned and result in the disorganization of muscle fibers.[1] This mutation also results in muscle cell death by apoptosis and necrosis.[1] The muscle cell may also be disorganized because the aggregates may interrupt other filament structures and/or normal cellular function.[2]
Desminopathies are very rare diseases and only 60 patients have been diagnosed with so far, however this number probably does not accurately represent the population due to frequent mis or under diagnosis.[2]
Presentation
Common symptoms of the disease are weakness and atrophy in the distal muscles of the lower limbs which progresses to the hands and arms, then to the trunk, neck and face. Respiratory impairment often follows.
Evaluation
AHA Scientific Statement: Management of Cardiac Involvement Associated With Neuromuscular Diseases
Cardiac Evaluation in Myofibrillar Myopathies (MFM)
| Class I |
| "1. Cardiology evaluation with examination, ECG, echocardiogram, and ambulatory electrocardiographic monitoring should take place at the time of MFM diagnosis, regardless of symptoms. (Level of Evidence: C) " |
| "2. Ambulatory electrocardiographic monitoring or monitoring with a looping event recorder should be performed for assessment of symptomatic palpitations in patients with MFM. (Level of Evidence: C) " |
| Class IIa |
| "1. It is reasonable to reassess asymptomatic patients with MFM annually with examination, ECG, and echocardiography. (Level of Evidence: C) " |
Inheritance
There are three major types of inheritance for this disease: Autosomal dominant, autosomal recessive and de novo.
- The most severe form is autosomal recessive and it also has the earliest onset.[2] It usually involves all three muscle tissues and leads to cardiac and respiratory failure as well as intestinal obstruction.[2]
- Autosomal Dominant inheritance shows a later onset and slower progression. It usually involves only one or two of the muscle tissues.[2]
- De novo diseases occur when a new mutation arises in the person that was not inherited through either parent. This form has a wide range of symptoms and varies depending on the mutation made.[2]
Treatment
There is currently no cure for the disease but treatments to help the symptoms are available.[2]
References
- ↑ 1.0 1.1 1.2 Bär H, Strelkov SV, Sjöberg G, Aebi U, Herrmann H (2004). "The biology of desmin filaments: how do mutations affect their structure, assembly, and organisation?". J. Struct. Biol. 148 (2): 137–52. doi:10.1016/j.jsb.2004.04.003. PMID 15477095. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Goldfarb LG, Vicart P, Goebel HH, Dalakas MC (2004). "Desmin myopathy". Brain. 127 (Pt 4): 723–34. doi:10.1093/brain/awh033. PMID 14724127. Unknown parameter
|month=ignored (help)