Siblings with nemaline myopathy: a case of rare genetic mutation

Authors

  • Zainali N. Merchant Department of Pediatrics, Sir T. General hospital and Government Medical college, Bhavnagar, Gujarat, India
  • Mehul M. Gosai Department of Pediatrics, Sir T. General hospital and Government Medical college, Bhavnagar, Gujarat, India
  • Jay H. Kaklotar Department of Pediatrics, Sir T. General hospital and Government Medical college, Bhavnagar, Gujarat, India
  • Akshat P. Shah Department of Pediatrics, Sir T. General hospital and Government Medical college, Bhavnagar, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20243486

Keywords:

Congenital myopathy, Nemaline myopathy, Nemaline rods

Abstract

Nemaline myopathy (NM) is a rare, congenital myopathy with varied clinical presentation. This case report talks about varied manifestation of this condition among siblings from same couple with a rare specific mutation at molecular level among the known mutations reported for NM. The subsequently mentioned patient had severe respiratory distress and recurrent respiratory tract infections since infant, which led to meticulous investigations and relevant family history charting. Such methods proved to be fruitful for suspecting and subsequently led to successful diagnosis of NM in the patient and aforementioned siblings. The diagnosis of NM was made with proper genetic testing, and patient was put on ventilatory support and appropriate physiotherapy for muscle weakness. Lower respiratory tract infections were treated with appropriate antibiotics and medications as and when required. To conclude this case report, advising adequate pre-conceptional genetic counselling to the couple having affected siblings with dire outcomes, which helps avoid the psychological, financial and medical demands of managing such conditions.

References

Winter JM, Ottenheijm CAC. Sarcomere Dysfunction in Nemaline Myopathy. J Neuromuscul Dis. 2017;4(2):99-113.

Laitila J, Wallgren PC. Recent advances in nemaline myopathy. Neuromuscul Disord. 2021;31(10):955-67.

Sewry CA, Laitila JM, Wallgren-Pettersson C. Nemaline myopathies: a current view. J Muscle Res Cell Motil. 2019;40(2):111-26.

Sanoudou D, Beggs AH. Clinical and genetic heterogeneity in nemaline myopathy-a disease of skeletal muscle thin filaments. Trends Mol Med. 2001;7(8):362-8.

North KN, Laing NG, Consortium I. Review article Nemaline myopathy: current concepts. Published online 1997:705-13.

Yin X, Pu C, Wang Z, Li K, Wang H. Clinico-pathological features and mutational spectrum of 16 nemaline myopathy patients from a Chinese neuromuscular center. Acta Neurol Belg. 2022;122(3):631-9.

Stoessl AJ. Nemaline Myopathy With Associated Cardiomyopathy. Arch Neurol. 1985;42(11):1084.

Meier C. Nemaline Myopathy Appearing in Adults as Cardiomyopathy. Arch Neurol. 1984;41(4):443.

Christophers B, Lopez MA, Gupta VA, Vogel H, Baylies M. Pediatric Nemaline Myopathy: A Systematic Review Using Individual Patient Data. J Child Neurol. 2022;37(7):652-63.

Howard RS, Wiles CM, Spencer GT, Howard RS, Wiles CM, Hirsch NP, et al. Respiratory involvement in primary muscle disorders: assessment and management. QJM An Int J Med. 1993;86(3):175-89.

Sahin S, Oncel M, Bidev D, Okur N, Talim B, Oguz SS. Miopatía nemalínica tratada con L-tirosina para aliviar los síntomas en un recién nacido. Arch Argent Pediatr. 2019;117(4):382-6.

Messineo AM, Gineste C, Sztal TE, McNamara EL, Vilmen C, Ogier AC, et al. L-tyrosine supplementation does not ameliorate skeletal muscle dysfunction in zebrafish and mouse models of dominant skeletal muscle α-actin nemaline myopathy. Sci Rep. 2018;8(1):11490.

Nguyen M-AT, Joya JE, Kee AJ, Domazetovska A, Yang N, Hook JW, et al. Hypertrophy and dietary tyrosine ameliorate the phenotypes of a mouse model of severe nemaline myopathy. Brain. 2011;134(12):3516-29.

Downloads

Published

2024-11-25

Issue

Section

Case Reports