[A late-onset case of oculopharyngeal muscular dystrophy carrying a (GCG)8 repeat expansion in the PAPBN1 gene].
We report a sporadic case of a female patient with oculopharyngeal muscular dystrophy (OPMD). Her father died at age 86 and mother at age 74. There was no familial occurrence of the disease. The patient initially developed a nasal voice at age 66. Neurological examinations on admission at age 72 revealed bilateral ptosis, a limitation of ocular movement without diplopia, dysphagia, and proximal muscle weakness. Serum creatine kinase level was slightly increased. Biopsied muscle specimens showed variation in fiber size as well as the occasional presence of rimmed vacuoles. On the basis of these clinical and laboratory findings, we suspected a diagnosis of OPMD, although a family history was absent. To confirm the diagnosis of OPMD, we performed a gene analysis for poly A binding protein, nuclear 1 (PABPN1; PABP2), which revealed a mild expansion of GCG repeat (8 repeats) as a heterozygous state. Clinical features of the patient were consistent with those in a previous literature reporting that patients carrying (GCG)8 repeat as a heterozygous state show a relatively late onset and a mild phenotype. The case of this patient emphasizes the importance of the PABPN1 gene analysis for patients showing muscular weakness involving oculopharyngeal and proximal limb muscles even when a familial occurrence of the disease is not apparent.
Tokutake
Takayoshi
T
Department of Neurology, Brain Research Institute, Niigata University.
Ikeuchi
Takeshi
T
Tanaka
Keiko
K
Onodera
Osamu
O
Nishizawa
Masatoyo
M
D000368:Aged; D005260:Female; D006580:Genetic Carrier Screening; D006801:Humans; D039141:Muscular Dystrophy, Oculopharyngeal / Q000235:genetics*; D010375:Pedigree; D010641:Phenotype; D039102:Poly(A)-Binding Proteins / Q000235:genetics*; D019680:Trinucleotide Repeat Expansion
D039102:Poly(A)-Binding Proteins