菲律宾成年男孩杜氏肌营养不良,口服皮质类固醇九年:一例报告

Erwin Damian V Marcelo, R. Rosales
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摘要

理由:杜氏肌营养不良症(DMD)是一种主要表现在生命早期阶段的疾病,逐渐影响肌肉力量,导致四肢瘫,最终导致继发于心脏或呼吸衰竭的过早死亡。DMD是儿童中最常见的x连锁遗传疾病,这是因为一种名为“肌营养不良蛋白”的蛋白质发生了改变,这种蛋白质负责增强肌肉纤维,并在肌肉收缩和放松时保护它们免受伤害。目的:报告一名19岁男性患者在8岁时被诊断为DMD,并接受口服皮质类固醇和康复治疗。病例:我们报告了一名19岁的男性,他出现了爬楼梯困难,并在8岁时通过临床外显子组测序被诊断为DMD。他开始了皮质类固醇治疗,并持续进行康复治疗,这大大提高了他的预期寿命。讨论与总结:我们对患者进行了临床外显子组测序,以确认DMD来自其他神经肌肉和神经退行性疾病的诊断。大多数DMD患者在成年前死于心肺骤停;然而,该病例是其他病例的典型例子,因为我们的患者能够通过继续口服皮质类固醇和康复而在没有广泛的生命支持的情况下延长生命。关键词:进行性肌无力,肌营养不良蛋白,过早死亡,DMD
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Duchenne Muscular Dystrophy in a Filipino Boy Reaching Adulthood, and Nine Years into Oral Corticosteroids: A Case Report
Rationale: Duchenne muscular dystrophy (DMD) is a disease that primarily manifests in the early stages of life and progressively affects muscle strength resulting in quadriparesis and ultimately resulting in premature death secondary to cardiac or respiratory failure. DMD is the most common x-linked genetic disorder in children that is because of an alteration of a protein called “dystrophin” which is responsible for strengthening muscle fibers and protecting them from injury as muscles contract and relax. Objective: To highlight the case of a 19-year-old male who was diagnosed with DMD at 8 years of age and treated with oral corticosteroid and rehabilitation. Case: We present the case of a 19-year-old male who developed difficulty climbing stairs and was diagnosed with DMD at 8 years old with the use of clinical exome sequencing. Corticosteroid therapy was initiated and rehabilitation perpetuated which dramatically improved his life expectancy. Discussion and Summary: Clinical exome sequencing was employed on our patient to confirm the diagnosis of DMD from other neuromuscular and neurodegenerative diseases. Most cases of DMD succumb to cardiopulmonary arrest before reaching adulthood; however, this case exemplifies DMD from other cases since our patient was able to prolong his life with continuation of oral corticosteroid and rehabilitation and in the absence of extensive life support. Key words: Progressive muscle weakness, Dystrophin, Premature death, DMD
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