病例报告:1例6岁男孩杜氏肌营养不良症

Christin Natalia Kalembang, I. Suwarba, Dewi Sutriani Mahalini, H. Saputra
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摘要

杜氏肌营养不良症(DMD)是一种由肌营养不良蛋白基因突变引起的x连锁隐性疾病。因此,身体无法合成肌肉收缩所需的蛋白质——肌营养不良蛋白。3 ~ 5岁男性DMD发病率为1:4 000。此外,患者还会出现功能衰退、行动不便和因心脏或呼吸衰竭而过早死亡。患者将在第二个十年开始时无法行走,通常在20多岁时死亡。我们在此报告一名男性,六岁表现为双腿无力。患者自3岁起有行走时反复跌倒及爬楼梯困难的病史。患者也难以立即从坐姿站起来。在站起来之前,他必须抓住自己的脚才能做出攀爬的动作。体格检查显示小腿肌肉假性肥大,高尔机动阳性。实验室检查示肌凝素激酶16.891,比正常值高约113倍。肌电图显示肌肉病变。左腓肠肌活检显示肌肉大小变化,无再生和纤维化。基因检测结果显示Dp427c和肌营养不良蛋白1-2外显子缺失。经皮质类固醇治疗一年,患者步态改善,双腿无力减轻。我们强调早期准确诊断DMD对提高生活质量的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Case Report: Duchenne Muscular Dystrophy in a 6-Year-Old Boy
Duchenne Muscular Dystrophy (DMD) is an X-link reccessive disorder, caused by mutation in dystrophin gene. Therefore body is incapable to synthesize dystrophin, the protein needed for muscle contraction. The incidence of DMD 1: 4000 male with age 3 to 5 years. Furthermore the patient will experience functional decline, loss of ambulation and early death due to cardiac or respiratory failure. Patient will be unable to walk at the beginning of second decade and usually decease at the age of 20s. Hereby we reported a male, 6-years-old presented with weakness on both of his legs. Patient had history of recurrent falls while walking and difficulty to climb stairs since 3-years-old. Patient also had difficulty to stand up immediately from sitting position. He had to grab his feet in order to make climb movement before stand up. Physical examination showed pseudo hypertrophy of calf muscle and positive Gower Maneuver. Laboratory examination showed creatinin kinase 16.891 (about 113 times higher than normal value). EMG revealed lesion of the muscle. Biopsy was taken from left muscle gastrocnemius and showed variability of muscle size without regeneration and fibrosis. The result of genetic test showed deletion of Dp427c and exon 1-2 of dystrophin gen. After been treated with corticosteroid for a year, the patient showed improvement in his gait moreover the weakness on both of his legs has became lessen. We emphasized the importance of early and accurate diagnosis of DMD for better quality of life.
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