Presentation
This form of muscular dystrophy presents with weakness of the pelvic and shoulder girdle in infancy or childhood, with symptoms usually present by the age of 12 years. Progression is rapid, and patients are usually wheelchair-bound in adolescence. [sema4genomics.com]
Exercise-induced cramps may be present. Calf hypertrophy affects some patients. Adults usually remain ambulant. Causes - Limb-girdle muscular dystrophy- type 2C Muscular dystrophy is caused by various genetic mechanisms. [checkorphan.org]
They often present with both weakness and sensory loss in a “ glove and stocking” fashion. [lecturio.com]
In the present investigation, we combined microspectrofluorimetry and electron microscopy techniques to investigate the physiological function and the ultrastructure of control and LGMD2C myotubes. [ncbi.nlm.nih.gov]
Only the first and second heart sounds were present. The lung fields were clear and the liver was not palpable. [chs-journal.com]
Entire Body System
- Weakness
Prognosis - Limb-girdle muscular dystrophy- type 2C Patients may also present with elevated CK levels without weakness but with myalgia and cramps, distal weakness, hypertrophic cardiomyopathy, or rippling-muscle disease. [checkorphan.org]
[…] and atrophy frequently associated with calf hypertrophy, diaphragmatic weakness, and/or variable cardiac abnormalities. [orpha.net]
Weakness of the muscles in the face (later in the disease) Weakness in the muscles of the lower legs, feet, lower arms, and hands (later in the disease) There are no known treatments that reverse the muscle weakness. [medlineplus.gov]
Onset of the disorder, progression rate and distribution of weakness are variable among the different subtypes of the disorder. [geneaware.clinical.bcm.edu]
- Disability
Some subtypes of LGMD1 can have central nervous system involvement with intellectual disability and/or epilepsy and rarely movement disorders. [mdfgauteng.org]
Complications of Muscular Dystrophies Disability and dependence on walking aids like wheelchairs due to muscular injuries and contractures. Osteopenia and osteoporosis due decreased mobilization and immobilization. [lecturio.com]
Some forms of the disorder progress to loss of walking ability within a few years and cause serious disability, while others progress very slowly over many years and cause minimal disability. [mda.org]
When limb-girdle muscular dystrophy begins in childhood the progression appears to be faster and the disease more disabling. Based on its cytogenetic location, this gene is considered as a candidate gene for limb-girdle muscular dystrophy. [diki.pl]
- Difficulty Walking
Outstanding symptoms are difficulty walking, climbing stairs, and frequent falls due to lower limb involvement. Approximately 2-5 years later, weakness is noted in the upper extremities. Some swaying of the back may be noted at this time as well. [wohproject.org]
Difficulties in rising from a chair or toilet seat and difficulties in climbing stairs are common. Eventually walking may become so difficult that a wheelchair or scooter is necessary for locomotion. [encyclopedia.com]
[…] stairs Difficulty walking up stairs 0003551 Difficulty running 0009046 Elevated serum creatine kinase Elevated blood creatine phosphokinase Elevated circulating creatine phosphokinase Elevated creatine kinase Elevated serum CPK Elevated serum creatine [rarediseases.info.nih.gov]
These patients will have difficulty walking (and will find it even harder to walk on their toes). [lecturio.com]
He was born at term and had no difficulties in the neonatal period. He started to walk at the age of 14 months and noted to have intermittent falls while walking without any clear reason from the age of 3 years. [omicsonline.org]
- Asymptomatic
The severity of the condition is greatly variable from wheelchair confinement at the age of 9 years to asymptomatic adults. Most tend to live to their third decade. [checkorphan.org]
In families with this type of LGMD, even asymptomatic individuals may develop signs of the disease at a later age. This means that healthy family members are also at some risk of having affected children. [geneticsofpregnancy.com]
Ambulatory holter monitoring showed asymptomatic pauses of up to 2.8 seconds and ventricular dysarrhythmias. A cardiac defibrillator was inserted. [omicsonline.org]
Dong M, Noguchi S, Endo Y, et al. (2015) DAG1 mutations associated with asymptomatic hyperCKemia and hypoglycosylation of α‐dystroglycan. Neurology 84 (3): 273–279. [els.net]
This is milder variant with early age of onset HyperCKemia in which asymptomatic individuals have only high serum creatine kinase (CK) concentrations. Usually, it occurs in young children. [annalsofian.org]
- Wheelchair Bound
Progression is rapid, and patients are usually wheelchair-bound in adolescence. Patients may also experience cardiomyopathy and lung disease, and may develop scoliosis and joint contractures as the disease progresses. [sema4genomics.com]
bound LGMD2H 8–27 years Wheelchair bound LGMD2I 1.5–27 years Wheelchair bound LGMD1A 18–35 years Proximal leg and arm weakness Distal weakness Tight Achilles tendon Problems with articulation of speech Nasal sounding speech LGMD1B 4–38 years (50% onset [encyclopedia.com]
Most individuals affected with limb-girdle muscular dystrophy type 2C (LGMD2C) start symptoms in early childhood and are wheelchair bound by about 12 years of age. Others have milder disease with onset in adolescence or adulthood. [geneaware.clinical.bcm.edu]
Over the next seven years her mobility deteriorated and she became wheelchair bound. Ambulatory holter monitoring showed asymptomatic pauses of up to 2.8 seconds and ventricular dysarrhythmias. A cardiac defibrillator was inserted. [omicsonline.org]
Six patients (8%) were wheelchair-bound and nonambulatory at the time of presentation and had attained this state 10-31 years after onset of symptoms. [neurologyindia.com]
Cardiovascular
- Heart Failure
Cardiac transplantation has been effective in some patients with LGMD1B and other subtypes who succumbed to end stage congestive heart failure [ 18, 19 ]. [pubs.sciepub.com]
Standard management of heart failure. Management of arrhythmias - eg, anticoagulation, pacemaker, implantable defibrillator. If there is severe cardiac impairment with good respiratory function, cardiac transplantation may be appropriate. [patient.info]
Cardiomyopathy is a progressive condition that may result in an impaired ability of the heart to pump blood; fatigue; heart block; irregular heartbeats (arrhythmias) and, potentially, heart failure. [rarediseases.org]
Musculoskeletal
- Myopathy
(MEGF10) DISTAL MYOPATHIES Distal myopathy with decreased caveolin 3 (CAV3) Miyoshi muscular myopathy (DSYF) Miyoshi muscular myopathy 3 (ANO5) Distal myopathy, with anterior tibial onset (DSYF) Distal myopathy 1, Laing (MYH7) Tardive tibial muscular [meduniwien.ac.at]
Endocrine Myopathies Thyrotoxic myopathy develops due to the overproduction of thyroid hormone. Hypothyroid myopathy develops due to the underproduction of thyroid hormone. Steroid myopathy can either be endogenous or exogenous. [lecturio.com]
This disorder has been named variously as hereditary inclusion body myopathy, distal myopathy with rimmed vacuoles, Nonaka myopathy, and quadriceps sparing myopathy. [annalsofian.org]
GeneReviews/NCBI/NIH/UW entry on Dysferlinopathy including Miyoshi Distal Myopathy (Miyoshi Myopathy), Limb-Girdle Muscular Dystrophy Type 2A (LGMD2A) Dysferlinopathy is characterized by progressive muscle wasting and is most often clinically diagnosed [diki.pl]
One case is reported as presenting with foot drop - aged 41. [ 24 ] LGMD 2B (dysferlin) also known as Miyoshi myopathy Late teens, early 20s May have distal myopathy (Miyoshi myopathy). Markedly elevated CKs. [patient.info]
- Muscle Weakness
Muscle weakness may be associated with soreness in the muscles and joint pain. [rarediseases.org]
In addition to proximal muscle weakness, there may or may not be: Distal muscle weakness. Muscle hypertrophy. Contractures. Involvement of the heart, respiratory muscles or tongue. (Facial weakness is not usual.) [patient.info]
OPMD has an adult age of onset, affecting both males and females, causing weakness in the eye muscles and throat. [centogene.com]
Limb-girdle muscular dystrophy includes a group of inherited disorders that cause muscle weakness and decreased amount of skeletal muscle involving the muscles around the hips and shoulders. [geneaware.clinical.bcm.edu]
[…] treatments that reverse the muscle weakness. [medlineplus.gov]
- Lordosis
Affected individuals may also have an abnormally curved lower back (lordosis) or a spine that curves to the side (scoliosis). Some develop joint stiffness (contractures) that can restrict movement in their hips, knees, ankles, or elbows. [medlineplus.gov]
Additional abnormalities that may develop in individuals with LGMD include abnormal side-to-side curvature of the spine (scoliosis), abnormal front-to-back curvature of the spine (lordosis), thickening and shortening of tissue that cause deformity and [rarediseases.org]
[…] strength in distal arms; LGMD2M FKTN / Fukutin Early childhood Very high Moderate Legs > arms; mild to moderate facial involvement LGMD2N POMT2 / protein O-mannosyl transferase 2 Early childhood High Slow Calf hypertrophy; scapular winging; skeletal lordosis [now.aapmr.org]
Children walk with waddle and exhibit lordosis. Cardiac involvement is known but not as common or prominent as in dystrophinopathies. [annalsofian.org]
Onset
- Onset in Adolescence
Others have milder disease with onset in adolescence or adulthood. This disorder may cause weakening of heart muscles in some people. They may also develop joint and spine deformities. Intellect is generally not affected. [geneaware.clinical.bcm.edu]
Neurologic
- Gowers Sign
Mild to moderate elevated serum creatine kinase levels and positive Gowers sign are reported. [orpha.net]
Image : “Gower’s sign.” by William Richard Gowers (1845–1915) – Gowers WR. Clinical lecture on pseudohypertrophic muscular paralysis. Lancet 1879;ii,73-5. [lecturio.com]
Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. [rarediseases.info.nih.gov]
Is there a finding (or history) of Gower's sign? This is seen in patients with proximal muscle weakness of the lower limb: when rising to stand, they use the hands as support, such that the hands 'climb up the legs'. [patient.info]
- Abnormal Gait
These symptoms have progressed to affect his gait, now walks with an abnormal gait (waddlimg) associated with lower back pain. [chs-journal.com]
- Paresis
Charcot-Marie-Tooth neuropathy, X-linked (GJB1) Charcot-Marie-Tooth disease, type 4A (GDAP1) Charcot-Marie-Tooth disease, axonal, type 2K (GDAP1) Charcot-Marie-Tooth disease, recessive intermediate, A (GDAP1) Charcot-Marie-Tooth disease, axonal, with vocal cord paresis [meduniwien.ac.at]
Workup
[…] molecular diagnosis is not worldwide available, and since a huge clinical variability can be observed in all forms of LGMDs, protein techniques with commercially available anti-telethonin antibodies should be introduced in a routine basis in the diagnostic workup [bmcclinpathol.biomedcentral.com]
Treatment
CLOSE Medical Disclaimer The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. [diseaseinfosearch.org]
A team of doctors or specialists is often needed to figure out the treatment options for each person. [1] Last updated: 8/9/2016 How might limb-girdle muscular dystrophy, type 2C (LGMD2C) be treated? There is no specific treatment for LGMD2C. [rarediseases.info.nih.gov]
More detailed information about the symptoms, causes, and treatments of Limb-girdle muscular dystrophy type 2C is available below. [checkorphan.org]
Treatment and management So far there are no specific treatments for LGMD2I, however managing the symptoms of the condition improves a person’s quality of life. Keeping mobile is important for all people affected with muscular dystrophy. [lgmd2i.com]
Prognosis
The symptoms are similar to DMD but often milder, and patients are less likely to have mental retardation and have a better prognosis (30-40 years instead of teens). [lecturio.com]
Prognosis - Limb-girdle muscular dystrophy- type 2C Patients may also present with elevated CK levels without weakness but with myalgia and cramps, distal weakness, hypertrophic cardiomyopathy, or rippling-muscle disease. [checkorphan.org]
Prognosis and management, therefore, are not uniform across the subtypes of LGMD2. Nonetheless, early identification of complications and risk factors is crucial. [mdfgauteng.org]
Prognosis: Most patients live into adulthood but progression is inevitable and all individuals eventually become totally disabled. Ancillary treatments and support: Respiratory therapy is important when diaphragmatic weakness becomes prominent. [wohproject.org]
Natural History of Cardiac and Respiratory Involvement, Prognosis and Predictive Factors for Long-Term Survival in Adult Patients with Limb Girdle Muscular Dystrophies Type 2C and 2D Fayssoil A, Ogna A, Chaffaut C, et al. [myobase.org]
Etiology
During the visit, the participant will be asked to fill out a couple of questionnaires asking questions about quality of life and activity limitations, as well as his/her understanding of their diagnosis with regards to etiology (or cause of their muscle [clinicaltrials.gov]
We ascertained a family in which five siblings presented with distal muscle weakness of unknown etiology. [scinapse.io]
Greenberg SA, Salajegheh M, Judge DP, et al. (2012) Etiology of limb girdle muscular dystrophy 1D/1E determined by laser capture microdissection proteomics. Annals Neurology 71 (1): 141–145. [els.net]
Etiology Currently, there are more than 30 different known LGMDs including the eight dominant (LGMD1A-H) and 23 recessive (LGMD2A-Y) types. [now.aapmr.org]
Epidemiology
This prompted us to search the scientific literature since 1990 for the epidemiology of NMDs. Objectives: To study occurrence rates, gender and age distribution. [scinapse.io]
Relevant External Links for DYSF Genetic Association Database (GAD) DYSF Human Genome Epidemiology (HuGE) Navigator DYSF Atlas of Genetics and Cytogenetics in Oncology and Haematology: DYSF No data available for Genatlas for DYSF Gene Analysis of the [genecards.org]
A Systematic Review and Meta-analysis on the Epidemiology of the Muscular Dystrophies. Can J Neurol Sci. 2016 Jan;43(1):163-77. doi: 10.1017/cjn.2015.311. Citation on PubMed Mitsuhashi S, Kang PB. [medlineplus.gov]
Other proteins involved include dystroglycan, fukutin-related protein, calpain, dysferlin and telethonin. [ 5 ] Epidemiology [ 2 ] The LGMDs individually are rare, with some forms reported in only a few families. [patient.info]
Pathophysiology
^ a b c d "Limb-Girdle Muscular Dystrophy: Practice Essentials, Background, Pathophysiology". [en.wikipedia.org]
The pathophysiological role of calpain-3 is not exactly known. Immunohistochemical (IHC) analysis of calpainopathy is still not possible as there is no anti-calpain-3 antibody available that is compatible for IHC on muscle biopsy cryosections. [neurologyindia.com]
Prevention
Management of the condition is based on each person's symptoms and may include: [4] Weight control to avoid obesity Physical therapy and stretching exercises to promote mobility and prevent contractures Use of mechanical aids such as canes, walkers, orthotics [rarediseases.info.nih.gov]
Prevention - Limb-girdle muscular dystrophy- type 2C Not supplied. Diagnosis - Limb-girdle muscular dystrophy- type 2C Not supplied. [checkorphan.org]
Some of the complications can be prevented with appropriate treatment. For example, a cardiac pacemaker or defibrillator can greatly reduce the risk for sudden death due to an abnormal heart rhythm. [medlineplus.gov]
This would entail close surveillance to recognize symptoms and to prevent detrimental sequelae. 2. [pubs.sciepub.com]
A physiotherapist can recommend stretches to keep joints supple and if necessary special splints (orthoses) to prevent muscle shortening (contractures) which are common in some types of LGMD. [mda.org.au]