Neuropediatrics 2001; 32(5): 267-270
DOI: 10.1055/s-2001-19122
Short Communication

Georg Thieme Verlag Stuttgart · New York

Congenital Nemaline Myopathy due to ACTA1-Gene Mutation and Carnitine Insufficiency: A Case Report

H. Buxmann1 , R. Schlösser1 , W. Schlote2 , A. Sewell1 , K. J. Nowak3 , N. G. Laing3 , V. v. Loewenich1
  • 1 Department of Paediatrics, University Hospital Frankfurt/Main, Germany
  • 2 Department of Neuropathology, University Hospital Frankfurt/Main, Germany
  • 3 Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Australian Neuromuscular Research Institute, Queen Elizabeth II Medical Centre, Nedlands, Australia
Further Information

Publication History

Publication Date:
18 December 2001 (online)

Abstract

A premature boy with a congenital form of nemaline myopathy due to mutation in the ACTA1-gene showed decreased carnitine levels in the eighth week of life. After sufficient oral carnitine substitution he improved gradually. In the first 15 months of life he made good progress; he reached full head control, learned to sit unsupported and was able to raise objects. At that time the carnitine levels were normal without substitution. Nemaline myopathy is clinically and genetically heterogenous. The pathogenesis of the muscle weakness is poorly understood. Disturbances of carnitine metabolism in this group of patients as one possibility are conceivable. Further investigations of carnitine metabolism in patients with nemaline myopathy may shed light on the pathogenesis of this entity.

References

  • 1 Banker B Q. The congenital myopathies. Engel AG, Banker BQ Myology, Basic and Clinical. New York; Mc Graw-Hill 1986: 1536
  • 2 Brooke M H. A Clinician's View of Neuromuscular Diseases. 2nd ed. Baltimore; Williams & Wilkins 1986: 362-365
  • 3 Conen P E, Murphy E G, Donohue W L. Light and elctronmicroscopic studies of “myogranules” in a child with hypotonia and muscle weakness.  Can Med Assoc J. 1963;  89 983-986
  • 4 Corbett M A, Robinson C S, Dunglison G F, Yang N, Joya J E, Stewart A W, Schnell C, Gunning P W, North K N, Hardeman E C. A mutation in alpha-tropomyosin (slow) affects muscle strength, maturation and hypertrophy in a mouse model for nemaline myopathy.  Hum Molec Genet. 2001;  10 317-328
  • 5 Donner K, Ollikainen M, Pelin K, Grönholm M, Carpén O, Wallgren-Pettersson C, Ridanpää M. Mutations in the β-tropomyosin (TMP2) gene in rare cases of autosomal dominant nemaline myopathy.  Neuromuscul Disord. 2000;  10 342-343
  • 6 Ilkovski B, Cooper S T, Noeak K, Ryan M M, Yang N, Schnell C, Durling H J, Roddick L G, Wilkinson I, Kornberg A J, Collins K J, Wallaca G, Gunning P, Hardeman E C, Laing N G, North K N. Nemaline myopathy caused by mutations in the muscle α-skeletal-actin gene.  Am J Hum Genet. 2001;  68 1333-1343
  • 7 Jockusch B M, Veldman H, Griffiths G, van Oost, Jennekens F GBA. Immunofluorescence microscopy of a myopathy. α-actinin is a major constituent of nemaline rods.  Exp Cell Res. 1980;  127 409-420
  • 8 Johnston J J, Kelley R I, Crawford T O, Morton D H, Agarwala R, Koch T, Schäffer A A, Francomano C A, Biesecker L G. A novel nemaline myopathy in the Amish caused by a mutation in troponin T1.  Am J Hum Genet. 2000;  67 814-821
  • 9 Laing N G, Majda B T, Akkari P A, Layton M G, Mulley J C, Phillips H, Haan E H, White S J, Beggs A H, Kunkel L M, Groth D M, Boundy K L, Kneebone C S, Blumberg P C, Wilton S D, Speer M C, Kakulas B A. Assignment of a gene (NEM1) for autosomal dominant nemaline myopathy to chromosome 1.  Am J Hum Genet. 1992;  50 576-583
  • 10 Laing N G, Wilton S D, Akkari P A, Dorosz S, Boundy K, Kneebone C, Blumbergs S, White S, Watkins H, Love D R. A mutation in the α-tropomyosin gene TPM3 associated with autosomal dominant nemaline myopathy.  Nature Genet. 1995;  9 75-79
  • 11 Matinez B A, Lake B D. Childhood nemaline myopathy: a review of clinical presentation in relation to prognosis.  Dev Med Child Neurol. 1987;  29 815-820
  • 12 McGarry J D, Foster D W. An improved and simplified radioisotopic assay for the determination of free and esterified carnitine.  J Lipid Res. 1976;  17 277-281
  • 13 McKusick V A. Mendelian Inheritance in Man. Catalogs of Autosomal Dominant, Autosomal Recessive and X-Linked Phenotypes. 11th ed. Baltimore; The Johns Hopkins University Press 1994: 1000-1001, 2057-2058
  • 14 Michele D E, Albayya F P, Metzger J M. A nemaline myopahy mutation in alpha-tropomyosin causes defective regulation of striated muscle force production.  J Clin Invest. 1999;  104 1575-1581
  • 15 North K N, Laing N G, Wallgren-Pettersson C, and the International Consortium an Nemaline Myopathy E NMC. Nemaline myopathy: current concepts.  J Med Genet. 1997;  34 705-713
  • 16 Nowak J K, Wattanasirichaigoon D, Goebel H H, Wilce M, Pelin K, Donner K, Jacob R L, Hübner C, Oexle K, Anderson J R, Verity C M, North K N, Iannaccone S T, Müller C R, Nürnberg P, Muntoni F, Sewry C, Hughes I, Sutphen R, Lacson A G, Swoboda K J, Vigneron J, Wallgren-Pettersson C, Beggs A H, Laing N. Mutations in the skeletal muscle α-actin gene in patients with actin myopathy and nemaline myopathy.  Nat Genet. 1999;  23 208-212
  • 17 Pelin K, Hilpela P, Donner K, Sewry C, Akkari P A, Wilton S D, Wattanasirichaigoon D, Bang M L, Centner T, Hanefeld F, Odent S, Fardeau M, Urtizberea J A, Muntoni F, Dubowitz V, Beggs A H, Laing N G, Labeit S, de la Chapelle A, Wallgren-Pettersson C. Mutations in the nebulin gene associated with autosomal recessive nemaline myopathy.  Proc Natl Acad Sci. 1999;  2 2305-2310
  • 18 Sewell A C. Methods of carnitine analysis. Seim H, Löster H Carnitine Pathobiochemical Basics and Clinical Applications. Bochum; Ponte Press 1996: 73-84
  • 19 Skyllouriotis M L, Marx M, Skyllouriotis P, Bittner R, Wimmer M. Nemaline myopathy and cardiomyopathy.  Pediatr Neurol. 1999;  20 319-321
  • 20 Shy G M, Engel W K, Somers J E, Wanko T. Nemaline myopathy. A new congenital myopathy.  Brain. 1963;  86 793-810
  • 21 Wallgren-Pettersson C, Laing N. 40th ENMC Sponsored International Workshop: Nemaline Myopathy. 2 - 4 February 1996, Naarden, The Netherlands.  Neuromuscular Disorders. 1996;  6 389-391
  • 22 Wallgren-Pettersson C, Jasani B, Newman G R. α-actinin in nemaline bodies in congenital nemaline myopathy: immunological confirmation by light and electron microscopy.  Neuromusc Disord. 1995;  5 93-104
  • 23 Wallgren-Pettersson C, Beggs A H, Laing N G. 51st ENMC International Workshop: Nemaline Myopathy, 13 - 15 June 1997, Naarden, The Netherlands.  Neuromuscular Disorders. 1998;  8 53-56
  • 24 Wallgren-Pettersson C, Pelin K, Hilpelä P, Donner K, Porfirio B, Graziano C, Swoboda K J, Fardeau M, Urtizberea J A, Muntoni F, Sewry C, Dubowitz V, Iannaccone S, Minetti C, Pedemonte M, Seri M, Cusano R, Lammens M, Castagna-Sloane A, Beggs A H, Laing N G, de la Chapelle A. Clinical and genetic heterogeneity in autosomal recessive nemaline myopathy.  Neuromusc Disord. 1999;  9 564-572

Prof. Dr. med. Volker von Loewenich

Klinikum der Johann Wolfgang Goethe Universität, Zentrum für Kinderheilkunde und Jugendmedizin, Abteilung für Neonatologie

Theodor Stern Kai 7

60590 Frankfurt am Main

Germany

Email: vloewenich@zki.uni.frankfurt.de

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