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KMID : 1189120190160020067
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대한의학유전학회지
2019 Volume.16 No. 2 p.67 ~ p.70
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A familial case of limb-girdle muscular dystrophy with CAV3 mutation
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Lee Seung-Bok
Jang Se-Song
Shim Young-Kyu
Kim Woo-Joong
Kim Soo-Yeon
Cho An-Na
Kim Hun-Min
Kim Jong-Il
Lim Byung-Chan
Hwang Hee
Choi Ji-Eun
Kim Ki-Joong
Chae Jong-Hee
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Abstract
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Limb-girdle muscular dystrophy (LGMD) is a group of muscular dystrophies that has extremely heterogeneous clinical features and genetic background. The caveolin-3 gene (CAV3) is one of the causative genes. LGMD appears as a clinical continuum, from isolated skeletal muscle involvement to long QT syndrome. Here we report two patients without apparent muscle weakness in a family with CAV3 mutation. A 7-month-old Korean boy visited our muscle clinic because of an incidental finding of elevated serum creatine kinase (CK) concentration (680 IU/L, reference range, 20-270 IU/L) without clinical symptoms. The patient was born after an uneventful pregnancy and showed normal developmental milestones. He developed pseudohypertrophy of his calf muscle during the follow-up. We obtained a muscle biopsy at age 14 months, which showed size variations and degenerating/regenerating myofibers with endomysial fibrosis and immunohistochemical evidence of normal dystrophin. Under the impression of LGMD, we performed target panel sequencing and identified a heterozygous in-frame mutation of CAV3, c.307_312delGTGGTG (p.Val103_Val104del). Immunohistochemical staining of muscle indicated complete loss of caveolin-3 compared with normal control muscle, which supported the variant’s pathogenicity. We performed segregation analysis and found that the patient’s mother had the same variant with elevated serum CK level (972 IU/L). We report on autosomal dominant familial caveolinopathy caused by a pathogenic variant in CAV3, which was asymptomatic until the fourth decade. This case highlights the utility of next generation sequencing in the diagnosis of muscular dystrophies and the additive role of muscle biopsy to confirm the variants.
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KEYWORD
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Muscular dystrophies, limb-girdle, Caveolin 3, High-throughput nucleotide sequencing, Creatine kinase
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