关键词: Cardiopathie Cardiopathy Diabetes mellitus Diabète Dominant autosomal transmission Familial partial lipodystrophy LMNA Laminopathies Lipodystrophies familiales partielles Myalgies Myopathy Transmission autosomique dominante

Mesh : Amino Acid Substitution Diabetes Mellitus, Type 2 / complications diagnosis genetics Diagnosis, Differential Female Heterozygote Humans Insulin Resistance / genetics Lamin Type A / genetics Lipodystrophy, Familial Partial / complications diagnosis genetics Middle Aged Mutation, Missense Phenotype

来  源:   DOI:10.1016/j.revmed.2017.04.006

Abstract:
BACKGROUND: Laminopathies (diseases related to A/C mutations of lamines) are rare genetic diseases with an extensive phenotypic spectrum, including lipodystrophic syndromes-characterized by a selective loss of adipose tissue-of which the partial Dunnigan family type is the most frequent.
METHODS: We report on a 55-year-old woman with diabetes and long-term disabling myalgia. Her cushingoid morphotype, associated with cutaneous lipo-atrophy and muscle hypertrophy in addition to a genetic heritage, led us to the diagnosis of complex partial familial lipodystrophy heterozygous LMNA_c.82C>T, p.Arg28Trp mutation.
CONCLUSIONS: Familial partial lipodystrophic syndromes may have varied phenotypes, mainly cardio-metabolic, which could mimic a particularly severe type 2 diabetes. The diagnostic work-up of this disease has to include a careful investigation of gait troubles and paroxysmal conduction that could lead to sudden death, as well as a genetic examination. In some cases, recombinant leptin can be proposed.
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