Congenital myasthenic syndrome in a cohort of patients with 'double' seronegative myasthenia gravis.


Journal

Arquivos de neuro-psiquiatria
ISSN: 1678-4227
Titre abrégé: Arq Neuropsiquiatr
Pays: Germany
ID NLM: 0125444

Informations de publication

Date de publication:
01 2022
Historique:
received: 08 12 2020
accepted: 27 02 2021
pubmed: 22 12 2021
medline: 13 4 2022
entrez: 21 12 2021
Statut: ppublish

Résumé

Congenital myasthenic syndromes (CMS) have some phenotypic overlap with seronegative myasthenia gravis (SNMG). The aim of this single center study was to assess the minimum occurrence of CMS misdiagnosed as double SNMG in a Brazilian cohort. The genetic analysis of the most common mutations in CHRNE, RAPSN, and DOK7 genes was used as the main screening tool. We performed genetic analysis in 22 patients with a previous diagnosis of 'double' SNMG. In this study, one CMS patient was confirmed due to the presence of compound heterozygous variants in the CHRNE gene (c.130insG/p.Cys210Phe). This study confirmed that CMS due to CHNRE mutations can be mistaken for SNMG. In addition, our study estimated the prevalence of misdiagnosed CMS to be 4.5% in 'double' SNMG patients of our center. Based on our findings, genetic screening could be helpful in the diagnostic workup of patients with 'double' SNMG in whom differential diagnosis is recommended.

Sections du résumé

BACKGROUND
Congenital myasthenic syndromes (CMS) have some phenotypic overlap with seronegative myasthenia gravis (SNMG).
OBJECTIVE
The aim of this single center study was to assess the minimum occurrence of CMS misdiagnosed as double SNMG in a Brazilian cohort.
METHODS
The genetic analysis of the most common mutations in CHRNE, RAPSN, and DOK7 genes was used as the main screening tool.
RESULTS
We performed genetic analysis in 22 patients with a previous diagnosis of 'double' SNMG. In this study, one CMS patient was confirmed due to the presence of compound heterozygous variants in the CHRNE gene (c.130insG/p.Cys210Phe).
CONCLUSIONS
This study confirmed that CMS due to CHNRE mutations can be mistaken for SNMG. In addition, our study estimated the prevalence of misdiagnosed CMS to be 4.5% in 'double' SNMG patients of our center. Based on our findings, genetic screening could be helpful in the diagnostic workup of patients with 'double' SNMG in whom differential diagnosis is recommended.

Identifiants

pubmed: 34932651
pii: S0004-282X2021005028203
doi: 10.1590/0004-282X-ANP-2020-0575
pmc: PMC9651496
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

69-74

Références

J Neuroimmunol. 2008 Sep 15;201-202:6-12
pubmed: 18707767
J Neurol. 2011 Jan;258(1):14-8
pubmed: 20852878
Neuromuscul Disord. 2014 Apr;24(4):353-9
pubmed: 24461433
Ann Neurol. 2008 Jul;64(1):71-87
pubmed: 18626973
Neuromuscul Disord. 2004 Jun;14(6):356-64
pubmed: 15145336
Eur J Hum Genet. 2020 Mar;28(3):373-377
pubmed: 31527857
Pediatr Neurol. 2012 Mar;46(3):141-8
pubmed: 22353287
Neuromuscul Disord. 2018 Nov;28(11):961-964
pubmed: 30266223
Brain. 2007 Jun;130(Pt 6):1497-506
pubmed: 17439981
Muscle Nerve. 2016 Oct;54(4):721-7
pubmed: 26910802
Arq Neuropsiquiatr. 2016 Sep;74(9):750-760
pubmed: 27706425
Neurology. 2016 Jul 26;87(4):419-25
pubmed: 27358333
Neuromuscul Disord. 2013 Jan;23(1):36-42
pubmed: 22884442
J Clin Neurosci. 2020 May;75:195-198
pubmed: 32238315
Neurology. 2019 Feb 5;92(6):e587-e593
pubmed: 30635494
J Child Neurol. 2004 Mar;19(3):175-82
pubmed: 15119478
Neurology. 2018 Nov 6;91(19):e1770-e1777
pubmed: 30291185
J Neurol Neurosurg Psychiatry. 2010 Sep;81(9):973-7
pubmed: 20562457
Muscle Nerve. 2013 Jul;48(1):151-2
pubmed: 23657916
Neurology. 2003 Sep 23;61(6):826-8
pubmed: 14504330
Muscle Nerve. 2011 Apr;43(4):574-7
pubmed: 21305573
J Neurol. 2018 Mar;265(3):708-713
pubmed: 29383513
Hum Mutat. 2012 Oct;33(10):1474-84
pubmed: 22678886

Auteurs

Paulo José Lorenzoni (PJ)

Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.

Renata Dal-Pra Ducci (RD)

Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.

Raquel Cristina Arndt (RC)

Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.

Nyvia Milicio Coblinski Hrysay (NMC)

Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.

Otto Jesus Hernandez Fustes (OJH)

Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.

Ana Töpf (A)

Newcastle University, Institute of Genetic Medicine, John Walton Muscular Dystrophy Research Centre, Newcastle upon Tyne, UK.

Hanns Lochmüller (H)

University of Ottawa, Children's Hospital of Eastern Ontario Research Institute, Department of Medicine, Division of Neurology, Ottawa, Canada.
University of Ottawa, The Ottawa Hospital, Brain and Mind Research Institute, Ottawa, Canada.

Lineu Cesar Werneck (LC)

Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.

Cláudia Suemi Kamoi Kay (CSK)

Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.

Rosana Herminia Scola (RH)

Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.

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Classifications MeSH