成年时诊断的线粒体肌肉病变:临床遗传谱和长期结果
Grayson Beecher1,2, Ralitza H Gavrilova1,3, Jay Mandrekar1
1Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Brain communications
|March 4, 2024
概括
成年人的线粒体肌肉病常常是晚期诊断出来的,呈现出缓慢渐进的软弱. 心脏参与显著增加了这些复杂的神经肌肉疾病的死亡风险.
科学领域:
- 神经学 神经学
- 遗传学 是一个遗传学.
- 病理学 病理学 病理学
背景情况:
- 线粒体肌肉病常常在儿童时期被诊断出来,但在成年人中经常被忽视.
- 成人发作的线粒体肌肉病变呈现出各种各样的临床和遗传特征.
研究的目的:
- 描述成年期线粒体肌肉病变的表型和基因型谱.
- 分析电诊断,肌病学发现和长期结果,包括生存.
主要方法:
- 在2005年至2021年期间诊断出线粒体肌肉病变的94名成年患者的回顾性图表审查.
- 对遗传缺陷 (mtDNA和nDNA),临床表型,电诊断研究,肌肉活检和生存数据的分析.
主要成果:
- 诊断年龄的中位数是48岁,从症状发作的时间中位数是11岁.
- 常见的表型包括多系统性疾病,脑肌病,四肢肌病和慢性渐进性外部眼.
- 在mtDNA (48%) 和nDNA (29%) 中发现了遗传缺陷;69%的中枢神经系统和21%的心脏参与.
- 骨肌肉衰弱缓慢进展;心脏参与与死亡率增加有关.
结论:
- 成人发病的线粒体肌肉病变表现出广泛的表型和基因型范围,往往有延迟诊断.
- 这些疾病的特点是肢体缓慢渐进的衰弱,频繁的多系统性参与,以及显著的死亡率,特别是心脏并发症.
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