title: Muscle MRI findings in a three-generation family affected by Bethlem myopathy.
abstract: We report clinical and muscle magnetic resonance imaging (MRI) findings in three individuals (aged 6, 26 and 73 years) from a three-generation family with Bethlem myopathy, confirmed by molecular genetic analysis which showed an exon skipping mutation in the COL6A1 gene. The clinical severity ranged from mild proximal weakness and distal laxity in the younger patients, to inability to stand or walk and severe contractures in the 76-year-old grandmother. The pattern of muscle involvement showed variable severity in parallel with the severity of motor function impairment. Although there was a marked variability in the severity of the MRI findings, it was possible to recognize a specific pattern of muscle involvement in all three patients. This consisted of involvement of the peripheral region of the vastus lateralis and hamstrings muscles with relative sparing of their central part. This was best appreciated in the third decade of life, but could also be identified both in the younger patient with minimal MRI changes and in the oldest patient, despite her more severe and diffuse muscle involvement. This report suggests that muscle MRI could be used as an additional tool to establish the pattern and the degree of muscle involvement in patients with Bethlem myopathy. Further studies in a larger cohort are needed to evaluate the specificity of these findings.
authors.affiliation: Dubowitz Neuromuscular Centre, Imperial College School of Medicine, Hammersmith Hospital, London, UK. e.mercuri@ic.ac.uk
authors.forename: Eugenio
authors.initials: E
authors.lastname: Mercuri
authors.forename: Claudio
authors.initials: C
authors.lastname: Cini
authors.forename: Serena
authors.initials: S
authors.lastname: Counsell
authors.forename: Joanna
authors.initials: J
authors.lastname: Allsop
authors.forename: Zuella
authors.initials: Z
authors.lastname: Zolkipli
authors.forename: Heinz
authors.initials: H
authors.lastname: Jungbluth
authors.forename: Caroline
authors.initials: C
authors.lastname: Sewry
authors.forename: Susan C
authors.initials: SC
authors.lastname: Brown
authors.forename: Guglielmina
authors.initials: G
authors.lastname: Pepe
authors.forename: Francesco
authors.initials: F
authors.lastname: Muntoni
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D024142:Collagen Type VI / Q000235:genetics*; D004252:DNA Mutational Analysis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D018482:Muscle, Skeletal / Q000473:pathology*; D009135:Muscular Diseases / Q000235:genetics* / Q000473:pathology*; D017354:Point Mutation / Q000235:genetics
chemical_list: D024142:Collagen Type VI