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Recessive variants of MuSK are associated with late onset CMS and predominant limb girdle weakness

Lookup NU author(s): Dr David Owen, Dr Ana TopfORCiD, Daniel CoxORCiD, Dr Teresinha Evangelista, John Dawson, Rachel ThompsonORCiD, Professor Hanns Lochmuller


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© 2018 Wiley Periodicals, Inc.Congenital myasthenic syndrome (CMS) is a heterogeneous disorder that causes fatigable muscle weakness. CMS has been associated with variants in the MuSK gene and, to date, 16 patients have been reported. MuSK-CMS patients present a different phenotypic pattern of limb girdle weakness. Here, we describe four additional patients and discuss the phenotypic and clinical relationship with those previously reported. Two novel damaging missense variants are described: c.1742T > A; p.I581N found in homozygosis, and c.1634T > C; p.L545P found in compound heterozygosis with p.R166*. The reported patients had predominant limb girdle weakness with symptom onset at 12, 17, 18, and 30 years of age, and the majority exhibited a good clinical response to Salbutamol therapy, but not to esterase inhibitors. Meta-analysis including previously reported variants revealed an increased likelihood of a severe, respiratory phenotype with null alleles. Missense variants exclusively affecting the kinase domain, but not the catalytic site, are associated with late onset. These data refine the phenotype associated with MuSK-related CMS.

Publication metadata

Author(s): Owen D, Topf A, Preethish-Kumar V, Lorenzoni PJ, Vroling B, Scola RH, Dias-Tosta E, Geraldo A, Polavarapu K, Nashi S, Cox D, Evangelista T, Dawson J, Thompson R, Senderek J, Laurie S, Beltran S, Gut M, Gut I, Nalini A, Lochmuller H

Publication type: Article

Publication status: Published

Journal: American Journal of Medical Genetics, Part A

Year: 2018

Volume: 176

Issue: 7

Pages: 1594-1601

Print publication date: 16/07/2018

Online publication date: 28/04/2018

Acceptance date: 20/03/2018

ISSN (print): 1552-4825

ISSN (electronic): 1552-4833

Publisher: Wiley-Liss Inc.


DOI: 10.1002/ajmg.a.38707

PubMed id: 29704306


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