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X-linked myopathy with postural muscle atrophy(XMPMA)

MedGen UID:
395525
Concept ID:
C2678055
Disease or Syndrome
Synonym: FHL1-Related Emery-Dreifuss Muscular Dystrophy, X-Linked
SNOMED CT: X-linked myopathy with postural muscle atrophy (773729007); XMPMA - X-linked myopathy with postural muscle atrophy (773729007)
Modes of inheritance:
X-linked recessive inheritance
MedGen UID:
375779
Concept ID:
C1845977
Finding
Source: Orphanet
A mode of inheritance that is observed for recessive traits related to a gene encoded on the X chromosome. In the context of medical genetics, X-linked recessive disorders manifest in males (who have one copy of the X chromosome and are thus hemizygotes), but generally not in female heterozygotes who have one mutant and one normal allele.
 
Gene (location): FHL1 (Xq26.3)
 
Monarch Initiative: MONDO:0010401
OMIM®: 300696
Orphanet: ORPHA178461

Disease characteristics

Excerpted from the GeneReview: Emery-Dreifuss Muscular Dystrophy
Emery-Dreifuss muscular dystrophy (EDMD) is characterized by the clinical triad of: joint contractures that begin in early childhood; slowly progressive muscle weakness and wasting initially in a humero-peroneal distribution that later extends to the scapular and pelvic girdle muscles; and cardiac involvement that may manifest as palpitations, presyncope and syncope, poor exercise tolerance, and congestive heart failure along with variable cardiac rhythm disturbances. Age of onset, severity, and progression of muscle and cardiac involvement demonstrate both inter- and intrafamilial variability. Clinical variability ranges from early onset with severe presentation in childhood to late onset with slow progression in adulthood. In general, joint contractures appear during the first two decades, followed by muscle weakness and wasting. Cardiac involvement usually occurs after the second decade and respiratory function may be impaired in some individuals. [from GeneReviews]
Authors:
Gisèle Bonne  |  France Leturcq  |  Rabah Ben Yaou   view full author information

Additional description

From OMIM
X-linked myopathy with postural muscle atrophy (XMPMA) is a progressive muscular dystrophy with onset in adulthood. Affected individuals develop a proximal myopathy characterized by specific atrophy of postural muscles, limited neck flexion, bent spine, contractures of the Achilles tendon, respiratory problems, and cardiomyopathy. Patients may show muscle hypertrophy in the early stages of the disorder (Windpassinger et al., 2008). The clinical features of Emery-Dreifuss muscular dystrophy (see EDMD1; 310300) classically include the triad of muscle weakness, joint contractures, and cardiac involvement, thus showing clinical overlap with XMPMA (Gueneau et al., 2009).  http://www.omim.org/entry/300696

Clinical features

From HPO
Back pain
MedGen UID:
2530
Concept ID:
C0004604
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) localized to the back.
Scapular winging
MedGen UID:
66822
Concept ID:
C0240953
Anatomical Abnormality
Abnormal protrusion of the scapula away from the surface of the back.
Cardiac arrhythmia
MedGen UID:
2039
Concept ID:
C0003811
Finding
Any cardiac rhythm other than the normal sinus rhythm. Such a rhythm may be either of sinus or ectopic origin and either regular or irregular. An arrhythmia may be due to a disturbance in impulse formation or conduction or both.
Hypertrophic cardiomyopathy
MedGen UID:
2881
Concept ID:
C0007194
Disease or Syndrome
Hypertrophic cardiomyopathy (HCM) is defined by the presence of increased ventricular wall thickness or mass in the absence of loading conditions (hypertension, valve disease) sufficient to cause the observed abnormality.
Scoliosis
MedGen UID:
11348
Concept ID:
C0036439
Disease or Syndrome
The presence of an abnormal lateral curvature of the spine.
Proximal muscle weakness
MedGen UID:
113169
Concept ID:
C0221629
Finding
A lack of strength of the proximal muscles.
Achilles tendon contracture
MedGen UID:
98052
Concept ID:
C0410264
Anatomical Abnormality
A contracture of the Achilles tendon.
Hamstring contractures
MedGen UID:
98375
Concept ID:
C0410266
Anatomical Abnormality
Muscular atrophy
MedGen UID:
892680
Concept ID:
C0541794
Pathologic Function
The presence of skeletal muscular atrophy (which is also known as amyotrophy).
Scapuloperoneal weakness
MedGen UID:
331234
Concept ID:
C1842161
Finding
Increased variability in muscle fiber diameter
MedGen UID:
336019
Concept ID:
C1843700
Finding
An abnormally high degree of muscle fiber size variation. This phenotypic feature can be observed upon muscle biopsy.
Rimmed vacuoles
MedGen UID:
340089
Concept ID:
C1853932
Finding
Presence of abnormal vacuoles (membrane-bound organelles) in the sarcolemma. On histological staining with hematoxylin and eosin, rimmed vacuoles are popcorn-like clear vacuoles with a densely blue rim. The vacuoles are often associated with cytoplasmic and occasionally intranuclear eosinophilic inclusions.
Spinal rigidity
MedGen UID:
346721
Concept ID:
C1858025
Finding
Reduced ability to move the vertebral column with a resulting limitation of neck and trunk flexion.
Skeletal muscle hypertrophy
MedGen UID:
853739
Concept ID:
C2265792
Finding
Abnormal increase in muscle size and mass not due to training.
EMG: myopathic abnormalities
MedGen UID:
867362
Concept ID:
C4021726
Pathologic Function
The presence of abnormal electromyographic patterns indicative of myopathy, such as small-short polyphasic motor unit potentials.
Respiratory insufficiency
MedGen UID:
11197
Concept ID:
C0035229
Pathologic Function
Impairment of gas exchange within the lungs secondary to a disease process, neoplasm, or trauma, possibly resulting in hypoxia, hypercarbia, or both, but not requiring intubation or mechanical ventilation. Patients are normally managed with pharmaceutical therapy, supplemental oxygen, or both.
Elevated circulating creatine kinase concentration
MedGen UID:
69128
Concept ID:
C0241005
Finding
An elevation of the level of the enzyme creatine kinase (also known as creatine phosphokinase (CK; EC 2.7.3.2) in the blood. CK levels can be elevated in a number of clinical disorders such as myocardial infarction, rhabdomyolysis, and muscular dystrophy.
Short neck
MedGen UID:
99267
Concept ID:
C0521525
Finding
Diminished length of the neck.
Limited neck flexion
MedGen UID:
350430
Concept ID:
C1864449
Finding
Reduced ability to lower the chin towards the chest by bending the neck.

Professional guidelines

PubMed

Yoneda ZT, Anderson KC, Estrada JC, Quintana JA, Strickland T, Montgomery JA, Michaud GF, Roden DM, Shoemaker MB
JACC Clin Electrophysiol 2021 Mar;7(3):410-412. Epub 2021 Jan 27 doi: 10.1016/j.jacep.2020.11.006. PMID: 33516708
Meaburn KJ, Cabuy E, Bonne G, Levy N, Morris GE, Novelli G, Kill IR, Bridger JM
Aging Cell 2007 Apr;6(2):139-53. Epub 2007 Feb 5 doi: 10.1111/j.1474-9726.2007.00270.x. PMID: 17274801
Yates JR, Bagshaw J, Aksmanovic VM, Coomber E, McMahon R, Whittaker JL, Morrison PJ, Kendrick-Jones J, Ellis JA
Neuromuscul Disord 1999 May;9(3):159-65. PMID: 10382909

Recent clinical studies

Diagnosis

Park YE, Kim DS, Shin JH
Clin Neurol Neurosurg 2019 May;180:48-51. Epub 2019 Mar 19 doi: 10.1016/j.clineuro.2019.03.015. PMID: 30928807
Schessl J, Feldkirchner S, Kubny C, Schoser B
Semin Pediatr Neurol 2011 Dec;18(4):257-63. doi: 10.1016/j.spen.2011.10.007. PMID: 22172421
Tzschach A, Ullmann R, Ahmed A, Martin T, Weber G, Decker-Schwering O, Pauly F, Shamdeen MG, Reith W, Oehl-Jaschkowitz B
Am J Med Genet A 2011 Nov;155A(11):2771-4. Epub 2011 Sep 19 doi: 10.1002/ajmg.a.34230. PMID: 21932316
Shalaby S, Hayashi YK, Goto K, Ogawa M, Nonaka I, Noguchi S, Nishino I
Neuromuscul Disord 2008 Dec;18(12):959-61. Epub 2008 Oct 25 doi: 10.1016/j.nmd.2008.09.012. PMID: 18952429

Prognosis

Chen T, Lu X, Shi Q, Guo J, Wang H, Wang Q, Yin X, Zhang Y, Pu C, Zhou D
Neuromuscul Disord 2020 Feb;30(2):165-172. Epub 2019 Nov 28 doi: 10.1016/j.nmd.2019.11.011. PMID: 32001145

Clinical prediction guides

Chen T, Lu X, Shi Q, Guo J, Wang H, Wang Q, Yin X, Zhang Y, Pu C, Zhou D
Neuromuscul Disord 2020 Feb;30(2):165-172. Epub 2019 Nov 28 doi: 10.1016/j.nmd.2019.11.011. PMID: 32001145
Emmanuele V, Kubota A, Garcia-Diaz B, Garone C, Akman HO, Sánchez-Gutiérrez D, Escudero LM, Kariya S, Homma S, Tanji K, Quinzii CM, Hirano M
Hum Mol Genet 2015 Feb 1;24(3):714-26. Epub 2014 Sep 30 doi: 10.1093/hmg/ddu490. PMID: 25274776Free PMC Article
Poparic I, Schreibmayer W, Schoser B, Desoye G, Gorischek A, Miedl H, Hochmeister S, Binder J, Quasthoff S, Wagner K, Windpassinger C, Malle E
PLoS One 2011;6(10):e26524. Epub 2011 Oct 28 doi: 10.1371/journal.pone.0026524. PMID: 22053194Free PMC Article
Shalaby S, Hayashi YK, Goto K, Ogawa M, Nonaka I, Noguchi S, Nishino I
Neuromuscul Disord 2008 Dec;18(12):959-61. Epub 2008 Oct 25 doi: 10.1016/j.nmd.2008.09.012. PMID: 18952429

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