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Systemic sclerosis in a patient with muscle dystrophy.

Sara Moutinho-Pereira1, Eurico Morais-de-Sá2, Helena Greenfield3

  • 1Department of Medicine, Service of Internal Medicine, Hospital Pedro Hispano, Matosinhos, Portugal sarasofia.pereira@ulsm.min-saude.pt.

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|September 13, 2022
PubMed
Summary

Genetic muscular dystrophy linked to a titin-cap/telethonin (TCAP) gene mutation may trigger systemic sclerosis. Mutant telethonin may mimic topoisomerase-I, potentially explaining the autoimmune disease development in this patient.

Keywords:
Connective tissue diseaseDrugs: respiratory systemGeneticsImmunologyInterstitial lung disease

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Area of Science:

  • Immunology
  • Genetics
  • Rheumatology

Background:

  • Systemic sclerosis is an autoimmune disease often causing lung fibrosis and associated with anti-topoisomerase-I antibodies.
  • Genetic muscular dystrophy involves titin-cap/telethonin (TCAP) gene mutations, potentially affecting sarcomere integrity.
  • A patient with TCAP gene mutation developed severe lung disease secondary to systemic sclerosis.

Observation:

  • A young man with TCAP gene mutation-related muscular dystrophy developed severe lung disease and systemic sclerosis with positive anti-topoisomerase-I antibodies.
  • Analysis revealed mutant telethonin shares sequence homology with an immunodominant site on topoisomerase-I.

Findings:

  • Mutant telethonin may expose a sequence recognized by anti-topoisomerase-I antibodies.
  • This homology suggests a potential autoimmune trigger for systemic sclerosis in the context of genetic muscular dystrophy.

Implications:

  • This finding offers a potential explanation for the co-occurrence of systemic sclerosis and genetic muscular dystrophy in this patient.
  • It highlights a possible link between sarcomere protein abnormalities and autoimmune disease development.