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Published on: May 24, 2016
[Familial congenital muscular dystrophy caused by phosphofructokinase deficiency]
Insights
This study identifies a rare congenital muscular dystrophy linked to phosphofructokinase (PFK) deficiency. This specific PFK deficiency presents in infants with severe muscle weakness and joint stiffness.
Area of Science:
- Biochemistry
- Genetics
- Pediatric Neurology
Background:
- Congenital muscular dystrophies (CMDs) are a group of inherited disorders characterized by muscle weakness present from birth.
- Phosphofructokinase (PFK) deficiency is a known cause of glycogen storage diseases, affecting muscle and red blood cells.
Observation:
- Two infants from a consanguineous family presented with severe congenital muscular defect and progressive joint stiffness.
- Muscle biopsy revealed abnormal glycogen accumulation and unequal muscle fiber size.
- Electron microscopy showed subsarcolemmal PAS-positive areas containing glycogen.
Findings:
- Biochemical analysis in the affected infant demonstrated moderate glycogen accumulation.
- Muscular enzymatic studies revealed a significant and isolated deficiency in phosphofructokinase (PFK) activity.
- PFK activity was normal in red blood cells and cultured fibroblasts, differentiating it from other known PFK deficiencies.
Implications:
- This specific PFK deficiency should be considered in the differential diagnosis of severe congenital muscular dystrophy with early-onset joint involvement.
- Understanding this distinct enzymatic defect can aid in earlier diagnosis and management of affected children.
- Further research into the genetic basis and precise biochemical pathway of this PFK deficiency is warranted.
Abstract:
Two children, born to related parents, presented since birth a muscular defect rapidly complicated by painful joint stiffness. The oldest child died at 6 months of age, from respiratory complications. The second-14 month old- does not sit without support. The muscle fibres are of unequal calibre and numerous fibres have under-sarcolemmal PAS positive areas contain glycogen, as seen on electron microscopy. In the second patient, the biochemical analysis showed a moderate glycogen accumulation and muscular enzymatic studies demonstrated an isolated and major deficiency in phosphofructokinase activity. Activity was normal in red blood cells and in fibroblasts cultured in vitro. Hence, these cases should be distinguished from formerly reported cases of phosphofructokinase deficiency. This type of P.F.K. deficiency should be looked for in patients with severe congenital muscular dystrophy and early joint involvement.
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