Acute rhabdomyolysis following viral infection with coxsackie A4 in a 50-day-old infant with Fukuyama congenital muscular dystrophy.
Acute Disease
Coxsackievirus Infections
/ complications
Diagnosis, Differential
Enterovirus A, Human
/ genetics
Female
Humans
Infant
Magnetic Resonance Imaging
Membrane Proteins
/ genetics
Polymerase Chain Reaction
Quadriplegia
/ etiology
RNA, Viral
Respiration, Artificial
Respiratory Insufficiency
/ etiology
Rhabdomyolysis
/ complications
Severity of Illness Index
Walker-Warburg Syndrome
/ complications
Creatine kinase
Fukutin
Mechanical ventilation
Quadriplegia
Respiratory failure
Retrotransposon
Journal
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
ISSN: 1437-7780
Titre abrégé: J Infect Chemother
Pays: Netherlands
ID NLM: 9608375
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
01
09
2019
revised:
07
11
2019
accepted:
21
12
2019
pubmed:
28
1
2020
medline:
11
11
2020
entrez:
28
1
2020
Statut:
ppublish
Résumé
Fukuyama congenital muscular dystrophy (FCMD), which is characterized by generalized muscle weakness, hypotonia, and motor delay during early infancy, gradually progresses with advanced age. Although acute rhabdomyolysis following infection in patients with FCMD has occasionally been reported, no studies have investigated rhabdomyolysis following viral infection in FCMD patients during early infancy. We report the case of a 50-day-old girl with no apparent symptoms of muscular dystrophy who developed severe acute rhabdomyolysis caused by viral infection, resulting in quadriplegia and respiratory failure therefore requiring mechanical ventilation. Brain magnetic resonance imaging incidentally showed the typical characteristics of FCMD, and FCMD was confirmed by genetic analysis, which revealed a 3-kb retrotransposon insertion in one allele of the fukutin gene and a deep intronic splicing variant in intron 5 in another allele. The virus etiology was confirmed to be Coxsackie A4. We report a severe case of acute rhabdomyolysis with the earliest onset of symptoms due to the Coxsackie A4 virus in a patient with FCMD. The present findings indicate that physicians should consider FCMD with viral infection a differential diagnosis if the patient presents with acute rhabdomyolysis following a fever.
Sections du résumé
BACKGROUND
BACKGROUND
Fukuyama congenital muscular dystrophy (FCMD), which is characterized by generalized muscle weakness, hypotonia, and motor delay during early infancy, gradually progresses with advanced age. Although acute rhabdomyolysis following infection in patients with FCMD has occasionally been reported, no studies have investigated rhabdomyolysis following viral infection in FCMD patients during early infancy.
CASE REPORT
METHODS
We report the case of a 50-day-old girl with no apparent symptoms of muscular dystrophy who developed severe acute rhabdomyolysis caused by viral infection, resulting in quadriplegia and respiratory failure therefore requiring mechanical ventilation. Brain magnetic resonance imaging incidentally showed the typical characteristics of FCMD, and FCMD was confirmed by genetic analysis, which revealed a 3-kb retrotransposon insertion in one allele of the fukutin gene and a deep intronic splicing variant in intron 5 in another allele. The virus etiology was confirmed to be Coxsackie A4.
CONCLUSION
CONCLUSIONS
We report a severe case of acute rhabdomyolysis with the earliest onset of symptoms due to the Coxsackie A4 virus in a patient with FCMD. The present findings indicate that physicians should consider FCMD with viral infection a differential diagnosis if the patient presents with acute rhabdomyolysis following a fever.
Identifiants
pubmed: 31983616
pii: S1341-321X(19)30384-8
doi: 10.1016/j.jiac.2019.12.015
pii:
doi:
Substances chimiques
FKTN protein, human
0
Membrane Proteins
0
RNA, Viral
0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
516-519Informations de copyright
Copyright © 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.