title: Late-onset autosomal dominant limb girdle muscular dystrophy and Paget's disease of bone unlinked to the VCP gene locus.
abstract: The broadwide spectrum of differential diagnoses of autosomal dominant muscular dystrophies in adults can be specified by additional features. The combination of late-onset muscular dystrophy, rimmed vacuoles and inclusion bodies in the muscle biopsy, and Paget's disease of bone suggests a mutation in the Valosin-containing protein gene (VCP, p97 or CDC48) even without dementia. We report on a German family with late-onset autosomal dominant muscular dystrophy starting in the pelvic girdle about age 40years, a subsequent rapidly-progressing course, high alkaline phosphatase and Paget's disease of bone. Clinical examination revealed no cognitive impairment. Histology showed myopathic changes with rimmed vacuoles and inclusion bodies on muscle biopsy. Mutations in VCP, filamin C, desmin, alphaB-crystallin, ZASP and myosin heavy chains 2 and 7 as well as the genes for facioscapulohumeral muscular dystrophy, Myotonic Dystrophy I and II, and LGMD1A-G were excluded by a combination of linkage analysis and direct sequencing. The family presented here suggests that a yet-unknown genetic defect can give rise to an autosomal dominant myopathy with Paget's disease but without dementia.
authors.affiliation: Division of Neuropediatrics and Muscle Disorders, University Children's Hospital Freiburg, Freiburg, Germany. michael.kottlors@uniklinik-freiburg.de
authors.forename: Michael
authors.initials: M
authors.lastname: Kottlors
authors.forename: Olaf
authors.initials: O
authors.lastname: Moske-Eick
authors.forename: Angela
authors.initials: A
authors.lastname: Huebner
authors.forename: Sabine
authors.initials: S
authors.lastname: Krause
authors.forename: Klaus
authors.initials: K
authors.lastname: Mueller
authors.forename: Wolfram
authors.initials: W
authors.lastname: Kress
authors.forename: Ralf
authors.initials: R
authors.lastname: Schwarzwald
authors.forename: Antje
authors.initials: A
authors.lastname: Bornemann
authors.forename: Verena
authors.initials: V
authors.lastname: Haug
authors.forename: Markus
authors.initials: M
authors.lastname: Heitzer
authors.forename: Janbernd
authors.initials: J
authors.lastname: Kirschner
mesh_terms: D000251:Adenosine Triphosphatases / Q000235:genetics*; D000328:Adult; D017668:Age of Onset; D018797:Cell Cycle Proteins / Q000235:genetics*; D005190:Family; D005260:Female; D005858:Germany; D006801:Humans; D007866:Leg / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology / Q000648:ultrastructure; D049288:Muscular Dystrophies, Limb-Girdle / Q000235:genetics* / Q000473:pathology; D009154:Mutation; D010001:Osteitis Deformans / Q000235:genetics* / Q000473:pathology; D010375:Pedigree; D010641:Phenotype; D000074405:Valosin Containing Protein
chemical_list: D018797:Cell Cycle Proteins; D000251:Adenosine Triphosphatases; C000614178:VCP protein, human; D000074405:Valosin Containing Protein