title: Congenital muscular dystrophy, myasthenic symptoms and epidermolysis bullosa simplex (EBS) associated with mutations in the PLEC1 gene encoding plectin.
abstract: Mutations in the PLEC1 gene encoding plectin have been reported in neonatal epidermolysis bullosa simplex with muscular dystrophy of later-onset (EBS-MD). A neuromuscular transmission defect has been reported in one previous patient. We report a boy presenting from birth with features of a congenital muscular dystrophy and late-onset myasthenic symptoms. Repetitive nerve stimulation showed significant decrement, and strength improved with pyridostigmine. Subtle blistering noticed only retrospectively prompted further genetic testing, revealing recessive PLEC1 mutations. We conclude that PLEC1 should be considered in the differential diagnosis of congenital muscular dystrophies and myasthenic syndromes, even in the absence of prominent skin involvement.
authors.affiliation: Department of Paediatric Neurology, Neuromuscular Service, Evelina Children's Hospital, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
authors.forename: Katharine
authors.initials: K
authors.lastname: Forrest
authors.forename: Jemima E
authors.initials: JE
authors.lastname: Mellerio
authors.forename: Stephanie
authors.initials: S
authors.lastname: Robb
authors.forename: Patricia J C
authors.initials: PJ
authors.lastname: Dopping-Hepenstal
authors.forename: John A
authors.initials: JA
authors.lastname: McGrath
authors.forename: Lu
authors.initials: L
authors.lastname: Liu
authors.forename: Stefan J A
authors.initials: SJ
authors.lastname: Buk
authors.forename: Safa
authors.initials: S
authors.lastname: Al-Sarraj
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wraige
authors.forename: Heinz
authors.initials: H
authors.lastname: Jungbluth
mesh_terms: D002648:Child; D016110:Epidermolysis Bullosa Simplex / Q000235:genetics*; D006801:Humans; D008297:Male; D009136:Muscular Dystrophies / Q000151:congenital* / Q000235:genetics*; D009154:Mutation; D051190:Plectin / Q000235:genetics*
chemical_list: C495332:PLEC protein, human; D051190:Plectin