关键词: Acetylcholinesterase inhibitors Congenital myasthenic syndromes Congenital myopathies KLHL40 Nemaline myopathies Neuromuscular junction

Mesh : Cholinesterase Inhibitors / therapeutic use Female Humans Infant Longitudinal Studies Muscle Proteins / genetics metabolism Muscle, Skeletal / metabolism pathology Myopathies, Nemaline / drug therapy genetics pathology Neurologic Examination

来  源:   DOI:10.1007/s00415-015-8015-x

Abstract:
Congenital myopathies are a group of inherited muscle disorders characterized by hypotonia, weakness and a non-dystrophic muscle biopsy with the presence of one or more characteristic histological features. Neuromuscular transmission defects have recently been reported in several patients with congenital myopathies (CM). Mutations in KLHL40 are among the most common causes of severe forms of nemaline myopathy. Clinical features of affected individuals include fetal akinesia or hypokinesia, respiratory failure, and swallowing difficulties at birth. Muscle weakness is usually severe and nearly half of the individuals have no spontaneous antigravity movement. The average age of death has been reported to be 5 months in a recent case series. Herein we present a case of a patient with a nemaline myopathy due to KLHL40 mutations (c.604delG, p.Ala202Argfs*56 and c.1513G>C, p.Ala505Pro) with an impressive and prolonged beneficial response to treatment with high-dose pyridostigmine. Myasthenic features or response to ACEI have not previously been reported as a characteristic of nemaline myopathy or KLHL40-related myopathy.
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